What causes numbness and tingling sensation in the hands and feet?
1. Numbness and tingling in hands and feet creeping up the legs
2. Troubke bending toes tbree look like hammertoes now
3. Numbness and tingling in face up to eyes
4. Eyes sometimes sting and burn even when first waking up
5. Slight runny nose no fever
6. Newly develpoed puffiness along both sides of nose
Need autoimmune workup as well as B12 and folic acid levels
Hi! Welcome to Healthcaremagic. Thanks for sharing your concerns with us. We will try to help you in best way possible. First of all it's sad to know what you had been going through lately.
Based on the history you have shared, though many of these symptoms correlate with some underlying autoimmune or rheumatological illness and should be evaluated by baseline ANA levels, CRP, ESR as well as RA factors to look for conditions like PMR, RA, myositis or SLE specially if symptoms occur more frequently in the morning like stiffness etc.
Levels of CPK and LDH can be sought before NCS and EMG alongwith serum electrolytes, and B12 and Folic acids. I know it's extensive set of investigations but if we think to fit all these symptoms in one set of diagnosis these tests are mandatory to rule out some common conditions which present like this.
Thyroid fucntions tests and blood sugars evaluation should also be done. Meanwhile supplements for calcium, B12, folic acid as well D3 should be started. OTC analgesics like acetaminophen can help with pain and stiffness.
The puffiness on face can be related to rheumatological diseases but should also be evaluated by renal and liver functions. A urinalysis to look for any signs of protien leak in urine should also be done. Keep good hydration and balanced diet meanwhile.
Wishing you a speedy recovery. Hope this has answered your query. If you have any questions please feel free to ask. Regards
Autoimmune workup is still awaited
Hi! Thanks for sharing the relevant details. NCS stands for nerve conduction studies to look for any nerve related causes like chronic demyelinating neuropathies etc for the cause of numbness and tingling you shared. It's good that most of baselines you shared are normal but more specific autoimmune workup like ANA, antiDS DNA, RA factor as well as endocrine issues like thyroid functions and sugar levels should also be done. A rheumatologist review would be helpful in this regard. Rest of the work up and possibilities will depend upon these reports. Regards
A detailed ENT examination and fungal cultures in secretions
Hi! Thanks for the feedback. Though mould or fungal infection can be a possibility however in presence of the possibilities that we have already discussed this should be a least possible diagnosis unless others are ruled out.
A detailed ENT examination of throat, nasal cavity for fungal spores or hyphae and fungal cultures though nasal swabs and throat swabs can be taken.
Meanwhile antifungals decision should be postponed untill any clear evidence comes through the said labs as other parameters of such mould infections are not met based on the history you had shared. Regards
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