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    Suggest treatment for tingling sensation and numbness in the limbs

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Posted on Fri, 23 Jun 2017 in Headache and Migraines
Question: Hello,
I'm a 39 yr old female 19 BMI exercises moderately. Type 1 diabetic well controlled. For the past year, I have been having episodes of tingling in numbness in all limbs, paralysis of legs for 3 hrs ( happened 3 times) and consistent episodes of confusion and memory loss- almost like XXXXXXX strokes. Blood work revealed hypogammaglobulinemia and positive rnp. Brain MRI normal. Cervical spine MRI:
Mild secondary arthrosis changes craniocervical junction and Atlantoaxial articulation
Developmental failure of ossification of dorsal arch c1 mild compenstorily enlarged anterior tubercle
C2-C3 mild decrease disc signal, mild uncinate osteophyte and facet arthrosis
C3-c4 mild decreased disc signal, bulge 1 mm w mild osteo. And facet arthrosis left foramen fine mild to mod right forminal stenosis
C4-c5 minor decreased disc signalmd to mod decreased disc height. Mild osteo and mild facet arthrosis, left mild foraminal stenosis mod right foraminal stenosis
C5-c6 moderate decreased signal, height, endplate spondylitic change w disc bulge- osteophyte complex greater on right one 2mm - mild left mild to mod right osteophyte. Severe canal stenosis 8-9 mm w ventral cord impingement and flattening. Normal cord signal remaining
Severe left and right foraminal stenosis.
C6-T1 are identical to c3-c4


I have never been in an accident and feel like I'm young for osteoarthritis.

Thank you in advance for your help
doctor
Answered by Dr. Sudhir Kumar 22 minutes later
Brief Answer:
Symptoms can be explained on the basis of cord compression at C5-C6 level.

Detailed Answer:
Thank you for posting your query.

I am Dr Sudhir Kumar, Neurologist, and I would try my best to help you.

I have noted your clinical details. Based on this, symptoms can be explained on the basis of cord compression, seen at C5-C6 level.

Gabapentin helps in relieving the tingling, burning or pain sensations. Other options include pregabalin or duloxetine capsules.

You should also wear a soft cervical collar. Physical therapy- neck extension exercises would also help.

In about 10% of cases, symptoms do not get better with above treatment, and surgery may be needed.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Sudhir Kumar 7 minutes later
Thank you! Should i be concerned of short term memory loss and confusion spells increasing in frequency? And w the severity of compression, wouldnt surgery be the only option especially because of the leg paralysis
doctor
Answered by Dr. Sudhir Kumar 9 minutes later
Brief Answer:
MRI/MR angiogram may be done.

Detailed Answer:
Thank you for getting back.

If memory loss and confusion spells persist, we would need to exclude TIAs (transient ischemic attacks). MRI/MR angiogram of brain may be done.

I agree, surgery may be preferable for the spine problem, in view of paralysis.

Best wishes,

Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
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Dr. Sudhir Kumar

Neurologist

Practicing since :1994

Answered : 5966 Questions

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