Brief Answer:
Cause of numbness/tingling

Detailed Answer:
Hi XXXX, thanks for asking from HCM.


I can understand your worry. It is sad that you are suffering from so many illness. But still you are able to work on laptop, which is good. You must remain active to be healthy.

You are sensory symptoms - tingling and numbness in all extremities. The distribution is of "Glove-stocking type". It resembles
"Peripheral sensory neuropathy (bilateral symmetrical)"

Your symptoms can be managed by confirming diagnosis and treating the diagnosis. Confirmation needs

: Neurological evaluation - Both neurological history and physical examination by neurologist. You have already taken appointment for that. Discuss some points with him/her about all sensory symptoms, any focal weakness, any painless burn/wound, history of diabetes/chronic illness, new skin lesion.

: After detecting some findings like either sensory, sensory-motor or only motor, the doctor will try to confirm it by investigations. You might be asked about MRI of spinal cord (cervical), nerve conduction velocity (NCV), electromyography (EMG).

: If still in doubt, the doctor might advise you biopsy (surgical excision of a piece of nerve) of peripheral nerve like Sural nerve from leg. It is 100% specific test.

After confirming diagnosis, next step is to find the cause behind neuropathy. Usual causes which are ruled out -

: Diabetic neuropathy - Investigated by blood sugar level, HbA1c level

: Alcohol - History and nerve biopsy

: Vitamin B12 deficiency - B12 level in blood

: Drug induced like

: Multivitamin deficiency like Thiamine, Folic acid, Pyridoxine

: Chemotherapy or radiation induced - If you have received for oesophageal cancer. Or "Paraneoplastic syndrome" due to hidden malignancy.

: Autoimmune disorder like lupus, Rheumatoid, Sarcoidosis etc.

You can ask your doctor about all the tests and probable cause of your symptoms. If he/she misses something, you can tell them it needs attention.

So now you have knowledge about your symptoms, cause of it and investigations needed for it. I will describe you the treatment after confirmation of diagnosis.

Hope it will help you. If still in doubt, do let me know.

Thanks. Take care.

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Brief Answer:
Thanks for appreciation and Multiple Sclerosis

Detailed Answer:
Hi XXXXXXX XXXX, welcome back.

Thanks for the appreciation. Yes, you are right that Multiple Sclerosis (MS) can present with similar features. Even tingling sensations are one of the earliest features of it. But in your case, I was not thinking about it due to age. Usually MS affects younger age group like 20-40 years. But it can occur at any age. So it must also be ruled out along with others. It is good that you have some good information. It will help your clinician and you.

As you are receiving Vitamin B12 injection, its deficiency is ruled out. Tell your doctor about it also and continue it.

Hope you got your information. If still in doubt, do let me know.

Thanks. Take care.

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