Hi Phil,

Sorry to hear you have so much going, but welcome to neurotalk.

I don't know if what I have to offer will be helpful. However, several of your symptoms caught my eye.

Have they considered any autoimmune diseases...like Sjogren's? In Sjogren's, the attack is against the exocrine system and salivary glands. It might explain the swollen submandibular salivary gland, as well as, the tightness in the jaw (parotid) and tingling in the tongue. Malaise/fatigue is also quite common in AI diseases.

Also, Sjogren's can include a vast array of neurological manifestations. I have Sjogren's and have significant neuro complications, many of which you list.

Of course, your symptoms could be related to something completely different. However, it may not hurt to be evaluated by a rheumatologist for an autoimmnue presence. There are blood markers for certain AI diseases and other diagnostic tools...like lip biopsy.

As for the neuro complaints, I didn't see a skin biopsy. This test is the best way to check for small fiber neuropathy, since EMG and nerve conduction studies do not evaluate small fibers.

There are many (100+) causes of neuropathy. Diabetes and low B12 are easy to check. You might consider a glucose tolerance test and B12 level.

I'm sure others will be by with input as well.