Hi all: Alan and I have this friend who is 49 (no family history of neuropathy by the way and is not a diabetic) He has just been diagnosed with Idiopathic Neuropathy. I asked him what his symtoms were and here is what he said.

1. Burning at times
2. Weak ankles
3. Pain when he stands (better if he doesn't stand)
4. No problem with his gait
5. his feet feel cold sometimes

His doctor thinks it might be bi-lateral tarsal tunnel but is not sure. He has had extensive tests (which I am putting the results into this post). He has been to many doctors and will see another neurologist yet again. He lives in Nevada

I wish I could put his whole nerve conduction test in this post but it came as a jpeg file and I can't do it.

But I will give you the impressions.
1. Right median and lateral plantar nerves neuropathy
2. All other remaining nerves as indicated above were within normal limits.

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And here is a report he received from a MRI he took.


1-TINEL sign- on worse right ankle Do NOT have the classic Tinel's sign but they say you can have tarsel tunnel without it. Usually their standard light tap elicits nothing but when they tap HARDER I get a very slight tingle into the big toe only and they are calling the response non dispositive since even normal people can get that especially when they tap harder than normal. On Left ankle side tapping even hard does nothing.
2- DECREASED ankle and knee tap reflexes on right side only. Dr. thought maybe coming from back but MRI and EMG did not show this and he said not overly concerned about it.
3- ATTACHED ARE THE NCV test results and ankle MRI. Doctors said NCV not totally dispositive but consistent with Tarsal tunnel only on right side. Doctors insist swelling/fluid in ankle on MRI not significant than many pain free people have it. they say MRI will not show Tarsel Tunnel Syndrome on MRI unless caused by a space occupying mass.

Here is the MRI report on the right ankle!!

MRI RIGHT ANKLE
CLINICAL HISTORY:
Anlde pain. No associated surgery.
TECHNIQUE:
Axial, coronal, and sagittal sequences perfomed without lV contast. No comparisons.
FINDINCS:
Nonnal bony aiignment without acute fractue or focal bone contusion. No significant tibiotald.ioint
fluid. No tarsal coalition or {alar dome OCD. Intact tarsal lunnel.
TENDONS: Mild posterior tibialis tenosynovitis at the rehomalleolar level to the subtalar middle facet joint level (a{ial fat-sat image 15). Mild peroneus brevis tendinosis at the submalleolar level (axial fat-sat image 23). Antedor ankle tendons are intact. lntact Achilles tendon. No Kager's fat pad edema.
LIGAMEN fS: Mild chronic deltoid ligament sprain (coronal fal-sat image 17). Tibiofibular, talohbular,
calcaneofibular, and spring ligaments are intact. Intact sious tarsi and plantar aponeuosis at d1e calcaneal attachment.
IMPRESSION:
I - Mild posterio r tibiali s tenosynovitis.
2. Mild peroneus brevis tendinosis.
3. Mild ohronic deltoid ligament sprain.

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He knows that Alan has had neuropathy for over 20 years and that I belong to the Neuropathy Support group. So he phoned me and asked if anyone can read these reports and give an opinion as to what they think is the reason for his neuropathy.

Any help is much appreciated. Oh, on all the tests he took, his back was ruled out as the cause and he is not diabetic. He did have low Vitamin D levels and his B-12 was in the 800. That's about all I know.

Thank to anyone who has clue.

Melody