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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Could Cause Numbness From Waist Down?

I m a 41 yr old male in good health. The bottoms of both my feet turned numb. Over the next 24 hours I became numb from the waist down. 5 days later I m not better. I went to a Neurologist and was examined. My eye sight is good, my reflexes are good, I have not had any muscle weakness, I have no pains, I don t smoke or drink and I have not been sick. I had blood taken at the hospital and the only thing was my glucose was 132 which I was told was a little high. I did eat and have a large soda 2 hours before. I went and had more blood drawn at a lab after fasting the next day. I m currently waiting on the results. Also my neurologist schedule me another appointment for a EMG in 10 days, because he thought if we did it any sooner it would not show anything. Is there anything else that should being done?
Fri, 24 May 2019
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Neurologist 's  Response
Hello,

You may be suffering from an acute demyelinating event which would be most likely occurring in the brain (and sounds to be purely sensory in nature) by your description although the spinal cord would also be a possible location to look for problems.

In my opinion, what you really need that would be obtainable NOW are imaging studies of the brain and spinal cord (MRI with gadolinium contrast) to rule out a type of demyelinating process in the brain or something such as transverse myelitis in the spinal cord.

Frankly, I don't understand the purpose of the EMG since you say you have normal reflexes and no muscle weakness.

Nothing will show on an EMG in 10 days from now that won't show up today BUT more importantly I wouldn't do that test anyways by the first intention simply because it is invasive (i.e. not very comfortable) and not likely to show anything more than you could diagnose with good clinical judgment if a solid history and examination were done.

EMG/NCV studies are MOST helpful when muscles are WEAK or reflexes are severely altered not as helpful when only sensory changes are occurring.

I would do the preliminary imaging studies, blood work is fine, waiting for a little time is fine as well but I don't think an EMG is something I would plan for unless you became noticeably weaker.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Dariush Saghafi, Neurologist
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What Could Cause Numbness From Waist Down?

Hello, You may be suffering from an acute demyelinating event which would be most likely occurring in the brain (and sounds to be purely sensory in nature) by your description although the spinal cord would also be a possible location to look for problems. In my opinion, what you really need that would be obtainable NOW are imaging studies of the brain and spinal cord (MRI with gadolinium contrast) to rule out a type of demyelinating process in the brain or something such as transverse myelitis in the spinal cord. Frankly, I don t understand the purpose of the EMG since you say you have normal reflexes and no muscle weakness. Nothing will show on an EMG in 10 days from now that won t show up today BUT more importantly I wouldn t do that test anyways by the first intention simply because it is invasive (i.e. not very comfortable) and not likely to show anything more than you could diagnose with good clinical judgment if a solid history and examination were done. EMG/NCV studies are MOST helpful when muscles are WEAK or reflexes are severely altered not as helpful when only sensory changes are occurring. I would do the preliminary imaging studies, blood work is fine, waiting for a little time is fine as well but I don t think an EMG is something I would plan for unless you became noticeably weaker. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist