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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Sore throat, white coating on tongue, intermittent tingling. Diagnosed with stenosis, neuralgia, B12 deficiency. Suggestions?

HI, My sister has multiple seemingly disconnected symptoms. She was recently hospitalized and no diagnosis could be generated. Symptoms started with sore tongue / throat, white coating on tongue and some swollen glands. This has been ongoing for more than a year. She has intermittent tingling in arms / legs, weakness. Was diagnoses with cervical stenosis in the spring of 2012. She suffered occular migraine after 10 days steroid use. About 4 weeks ago developed cognitive difficulties, mental confusion , word finding difficulties and these issues increased over 2 weeks after which she was hospitalized. TSH values dramatically increased from 2.0 to 10:07, but all other lab values basically in range. Family doctor explored possibility of B12 deficiency. Her symptoms continue as tingling up the back of the neck / head over the eyebrow and down the right side of the face and periods of cognitive difficulty. Brain MRI revealed no lesions / tumors or other issues. Cervical MRI revealed slightly worsening stenosis. The hospital ruled out Stroke, aneurism, MS, vascular blood flow issues. One doctor suggested heavy metal poisoning, neurologist suggests neuralgia - but this does not account for some symptoms. We are just looking for possibilities as she feels miserable. Her episodes of confusion or cognitive difficulty are quite debilitating and other bodily sensation can be scary. She is 44 and previously in reasonable health. Any suggestions would be appreciated. M
Wed, 24 Jul 2013
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General & Family Physician 's  Response
hi...
yes B12 DIFICIENCY IS LIKELY....
coated tongue with neurological sign symptoms are suggestive of B12.especially if the patient did not take meat in diet or he or she is alkohlic .or there is conginital defect in its absorption from intestine.....
put the patient on B12,if respond diagnoses confimed,if not then need further evaluation for other posible diagnoses....
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