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What Causes Pins And Needles Sensation In The Arms And Legs?

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Posted on Fri, 31 Mar 2017
Question: Follow up from my previous questions.

32 m. Pins/needles/ burning in arms legs, and other parts of body. almost like a shock like pain. Thighs, wrists, groin area, sometimes facen ect. They come and go for no reason seem to jump around from spot to another spot in matter of seconds., I noticed that when i exercise the first 10- 20 mins they flare pretty bad until i get a really good sweat then it seems a little better. Sensitive to temperature. After sex if flares too, i also get very itchy everywhere after that. Brain mri normal. Neuro exam was normal except he said i had jumpy reflexes. Neck mri showed mild mutlilevel degenerative disc disease, most notably at c5 c6. At c6 c7 minimal central protrusions, no stenosis.
Still cannot find cause for symptoms. One doc said sounded like small fiber neuropathy. scheduled for a emg but that only shows large fibers.

Any ideas? could jumpy reflexes be a clue?
doctor
Answered by Dr. Dr. Erion Spaho (6 hours later)
Brief Answer:
Jumpy reflexes may be linked to several conditions.

Detailed Answer:
Hello again and thanks for your follow-up questions,

I have read your query and understand your concerns.

It is true that nerve conduction study and EMG assess the function of large nerve fibers only and are thus normal in small fiber neuropathy.

However, nerve conduction study and EMG both are necessary to exclude sub-clinical involvement of large nerve fibers.

Tests needed to asses small fibers neuropathy include skin biopsy to calculate nerve fibers of the dermis, and tests of autonomic nerves function.

Jumpy reflexes, or hyperreflexia mostly is encountered in conditions that cause spinal cord injury and this is excluded by your MRI.

Other conditions that may cause jumpy reflexes include electrolytes imbalance, hyperthyroidism, side effects of certain drugs, multiple sclerosis, etc.

So, the causes may be several and further testing is necessary to narrow the possibilities.

In some cases, there is just jumpy reflexes, without any underlying cause.

Hope I helped you. Let me know if I can assist you further.

Kind regards.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Dr. Erion Spaho (13 minutes later)
Ok, so my neck mri is of no concern? (degenerative disc disease, and minimal protrusion)

My jump reflex was in my knee reflex. Couldn't that be from lumbar or thoracic spine? I only had mri of neck.

In the case of small fiber neuropathy, i would have to have a non length dependent case as the pins are kind of all over and not in a typical stocking glove presentation. It seems that non length dependent is rare and usually caused by inflammatory or autoimmune diseases from what i have read, but which ones?
doctor
Answered by Dr. Dr. Erion Spaho (13 hours later)
Brief Answer:
Thoracic spine to be considered too.

Detailed Answer:
Welcome back.

MRI findings of your cervical spine may justify some mild symptoms such pain and minor sensory disturbances, but can't be related to jumpy reflexes, since there's no stenosis or myelomalacia.

If there was a problem with your lumbosacral spine, the legs reflexes should have been diminished.

Thoracic spinal cord conditions may justify jumpy reflexes and a MRI is necessary in such cases.

Autoimmune diseases that may cause small fibers neuropathy include Sjögren's syndrome, Lupus, vasculitis, sarcoidosis, etc.

Hope this helps.

Feel free to ask if you have any other questions.

Take care.
Above answer was peer-reviewed by : Dr. Kampana
doctor
Answered by
Dr.
Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4493 Questions

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What Causes Pins And Needles Sensation In The Arms And Legs?

Brief Answer: Jumpy reflexes may be linked to several conditions. Detailed Answer: Hello again and thanks for your follow-up questions, I have read your query and understand your concerns. It is true that nerve conduction study and EMG assess the function of large nerve fibers only and are thus normal in small fiber neuropathy. However, nerve conduction study and EMG both are necessary to exclude sub-clinical involvement of large nerve fibers. Tests needed to asses small fibers neuropathy include skin biopsy to calculate nerve fibers of the dermis, and tests of autonomic nerves function. Jumpy reflexes, or hyperreflexia mostly is encountered in conditions that cause spinal cord injury and this is excluded by your MRI. Other conditions that may cause jumpy reflexes include electrolytes imbalance, hyperthyroidism, side effects of certain drugs, multiple sclerosis, etc. So, the causes may be several and further testing is necessary to narrow the possibilities. In some cases, there is just jumpy reflexes, without any underlying cause. Hope I helped you. Let me know if I can assist you further. Kind regards.