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Old 09-21-2011, 08:18 AM #1
indylee indylee is offline
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Default Loss of pain sensation

Hello,

I will start at the beginning, in the hope that someone else may have had/or have similar things going on as what I do

1.5 years ago I noticed that the find touch sensation in my left hand was less. For example grabbing a fine piece of paper felt weird. My hand responds fine, but I can't feel it exactly like it should be. It is not like a glove feeling at all.

(6 months previous to this I had an episode in my left eye where I had a brown veil appear in my vision. I sought help with an eye specialist, who diagnosed my vitreous shrinking, which he said explained the flashing I was seeing off and on for a month. After the month all eye symptoms disappeared. My vision is 100%.)

About 6 months ago I noticed that the same sensation I was having in my left hand was now in my right hand. I organised to see my GP, but in the week waiting for the appointment I started to get weird sensations of feeling out of it, like my brain was fuzzy. I had trouble concentrating, words were hard to get out...I felt like I was ghost like, in a dream. My arms felt like they were very very relaxed and I needed to wake them up. They weren't numb though.

I also started to notice the same feeling in my top lip and it felt weird to talk, like my lip wasn't real. These extra sensations lasted about 4 days. By the time I got to the GP all I had was the arms not feeling right.

The GP did some basic Neuro tests, ran a feather over my arms/hands, strength, cold, hot then she got out a scapel (she coudn't find her pricking pin!) and started to poke it into my hands (without cutting me).

I couldn't feel the pin prick. She then pricked the scapel up my arms, same thing I couldn't feel it. I thought perhaps it was blunt, but then she stuck it in an area where I could feel and I almost jumped off the table!

I was referred to a Neurologist immediately, well it did take about 2 weeks though until a time was available.

Whilst waiting I had another episode of the weirdness as explained above, this time it only lasted three days (and i haven't had one since but the arms/hand sensation are still not working).

I finally got to the appointment with the Neuro.
He did extensive testing - balance, strength, heat, cold, vibration (which all were perfect) and then finally pin prick.

He did my hands and arms, couldn't feel it. He did both arms and we found there was a track on the exact same spot on both arms where I could feel the pain.

He then ran the pin up further and it was then I discovered that I also cannot feel pin prick sensation in my neck, face, ears and scalp.
I can feel it below my collar bones, and from the base of my hairline at the back but the space in between them I can't feel it.

I was then given nerve conduction tests, which all came back normal.

MRI was done a week later, once again completely normal (except for a small incidental finding of a lump on my thyroid for which I have had a biopsy and all is fine).
I have no compacted discs, no nerves with pressure on them, no distortions in my spine.
I do not have MS, I do not have any tumours.

Next was the Lumbar Puncture. This showed nothing as well. Opening pressure was 29, but they said that it would have been higher due to stress??(I did think of Intercranial hypertension)

I had a review with the Neuro earlier this week, he is stumped as the pain recptors run ont he same nerve as the one that feels temperature...and I can feel that!

Next step is to do a sleep deprived EEG and then another deeper brain scan MRI with comparisons. (he is thinking that perhaps the weirdness coming and going could be a seizure? but that wouldn't explain the loss of pin prick sensation?)

I have been tested for every disease, blood disorder/deficiency there is. I don't have anything. He even suggested leprosy and I had to check that I had not been exposed to it as a child (which I haven't). I have never been out of Australia, or to any 3rd world countries....so that one is ruled out.

My blood sugar is fine, in fact everything is fine..I am super healthy...except for this weird sensation in my hands and the weirdness that seems to come and go.

So anyone got any clues ? LOL

Oh and he did ask me at the last appointment if I was 'bunging it on'....why would one bother to make all of this up!
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Old 09-21-2011, 08:32 AM #2
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Welcome to NeuroTalk:

I have some ideas for you:

1) did they do a B12 test on you? Please get the numbers because interpretation of them has changed in the last decade and labs often report lows as "normal". So do get your numbers including nmol/L or pg/ml because this makes a difference here in US. nmol has to be converted to pg/ml for our references here.

2) I'd get a Vit D test too, as strange feelings in the face/lips etc can reflect poor calcium utilization. Many people are testing very low in Vit D today.

When you say comes and goes? When does that happen?
Some low blood sugars will cause numbness.

There is a new test here in US called a skin punch biopsy. It is more accurate in determining if the nerve receptors in the extremities are dying off. EMGs do not as a rule identify sensory problems. But I don't know if you have that where you are.
Many of our Peripheral Neuropathy posters get this test and it can reveal quite a bit. Typically it is done in the ankle and thigh to show if the nerve endings are normal in concentration.

Gluten intolerance can cause all sorts of problems with the nerves. Were you evaluated for this? We have a gluten forum here you can read as well. You must be eating gluten if you get testing done. But you can try a gluten free diet for 3 months and see if you feel better. Sometimes this can even mimic MS.
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Old 09-21-2011, 08:47 AM #3
indylee indylee is offline
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Default

I have had the B12 and Vit D tests and both are fine.

It seems about a couple of times a month, with spaces of 6-8 weeks inbetween episodes is when I feel like I am a zombie. I just don't feel right, spaced out, fuzzy, have trouble concentrating, getting words out etc and it just hits like 'bam' it doesn't build up, then after a few days it goes.

I don't have numbness, nothing is numb.

I think it was mentioned about eh skin punch biopsy but they decided that it wasn't necessary as my nerve conduction tests came back normal.

No I haven't been checked for gluten intolerance, will go and look at what the symptoms are.
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Old 09-21-2011, 09:11 AM #4
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Nerve conduction tests cannot determine small fiber neuropathy. The definitive test is skin punch biopsy

http://en.wikipedia.org/wiki/Small_f...ral_neuropathy

"In fact, nerve conduction tests and electromyography (EMG tests), which are good in diagnosing other neuropathies, are usually bad in detecting small fiber neuropathies."
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Old 09-21-2011, 05:01 PM #5
indylee indylee is offline
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Quote:
Originally Posted by en bloc View Post
Nerve conduction tests cannot determine small fiber neuropathy. The definitive test is skin punch biopsy



"In fact, nerve conduction tests and electromyography (EMG tests), which are good in diagnosing other neuropathies, are usually bad in detecting small fiber neuropathies."

Thank you so much for that. There is so much that I don't understand. This was talked about being done before the Nerve Conduction test but has never been spoken off again, I will ring today and mention the possibility of having it done.
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