Hi - I'm new to this message board and would like to hear from others with similar problem in the hopes that I am heading in the right direction. I'm in my late 30's and have no other health problems or injuries.

About 6 months ago, I begin having a fierce burning sensation in both of my palms. It felt truly and painfully *hot* -- touching cold things, ice packs, etc... really helped. It lasted for a week or two and then was gone.

Around that time I found that my fingertips were really lacking in sensation. But it's subtle... I can feel solid objects, but I can't feel hair or thread or cloth or texture or still water... anything that bends. I feel a little crazy when I try to explain. It also takes a few seconds for me to figure out whether something is hot or cold. It is constant and affects both hands and all fingers.

I went to the neurologist who didn't really do much except a very quick NCS and EMG. He said that the velocity was a little slow and suggestive of Carpal tunnel in one hand. I'm not sure that's right because I don't do any repetitive actions, it came on all at one time and I didn't have a pins and needles feeling. I wore wrist braces and took vitamin B-6 and after two months of no change, decided that was enough.

More recently, I have had some pins and needles sensation at night, but only in my pinky and ring finger. I have woken up lately to find that I had total numbness and couldn't move those fingers until I shook them. I also wonder, though I'm not sure about it, whether I might have some minor atrophy in my hand. I do have a little trouble with things like peeling an onion or buttoning a button or other fidgety little things, but I'm not sure if that's a sensory issue or a motor one.

Also, recently I was playing with my cat and while I could feel her biting and scratching at my hand, it really didn't hurt at all. It scares me a little to realize this, but I don't think I feel pain anywhere on my skin.

In one sense, it's not that big of a deal -- I'm not hurting and the loss of function is not huge. But... it is a bit depressing to me to be unable to feel my children's skin or the texture of cloth or to pet the dog and actually feel her fur. So if I want to dig for an answer, who should I see about this? My GP has tested for B-12 deficiency twice. I get the feeling that whichever specialist I head to, I'll get their take on it... a rheumatologist will think it's some kind of systemic autoimmune issue or a neurologist will think it's spine related and an orthopedist will look for bone spurs or an endocrinologist will think it's a neuropathy from thyroid or diabetes or something. Anyway, what to do? I'd like someone to tell me it's all completely normal and nothing to worry about, but I'm pretty sure I can no longer believe that.

Welcome to NeuroTalk:

First off get those results of the B12 testing. Lab ranges are outdated in the US and go down in regions where nerve damage can occur for some people.

If you are below 400pg/ml, you are going to have to supplement it.

Also get your Vit D tested. Low D is very common today. When D is low calcium levels get messed up and pain can occur in odd places on the body.

There can be nerve compressions at the elbow, or neck. Some people have a pressure palsy which can be hereditary.
http://en.wikipedia.org/wiki/Heredit...pressure_palsy

What were you doing when your palms flared up? Can you remember? Taking a drug for infection? Or statins for cholesterol? vaccines? Handling toxins, chemicals, solvents?
some kind of exercise? lifting weights, push ups etc?
Is this worse when you are hungry? Does eating relieve some symptoms? Are both hands affected equally?

Nothing in the feet?

Have you tried using the carpal tunnel wrist supports/splits at night? They take the pressure off the wrist while you sleep.

Hereditary Neuropathy with Liability to Pressure Palsies (HNPP) is the opposite of CMT1A. HNPP has a deletion (loss of copy) of PMP22 and CMT1A has an extra copy.

A good site explaining it:

http://www.hnpp.org/

Thanks for the reply - my vitamin d is normal and b12 was in the 600's. I used carpal tunnel braces for 2 months without any change. When the very first symptoms came up, I was on vacation. We had rolling carry-ons so I wasn't carrying much. It was pretty hot, but other than that we had a pleasurable time. The sensory loss in my fingertips has been constant and effects all 10 fingers equally. The last two fingers go numb in a different way - paralyzed and totally numb with tingling, not just sensory loss. That happens sporadically and one sided and is temporary and related to compression - like a bent elbow. It started last month. I don't take medications or have exposure to toxins. When I touch my toes with my fingers, I only feel it in my toes, so if there is sensory loss there, it's not as noticeable as my fingers. I do sometimes have a buzzing feeling in my feet, but it's not bothersome to me. My toes will go blue when sitting or in the shower, so but I think I'm too young and active for circulation problems.

I'm going to look into the hereditary pressure problem. I hate being hypochondriacal about this, but I don't know what else to do.

Blue toes does not sound good to me! In the shower with the
warm water?

No one here thinks you are hypochondrical. We are all used to
odd sensations and puzzling things.

Start keeping a journal of when you have the various symptoms.
How long they last, etc. When this happens what you are doing, or not doing, and what you are eating.

Some people are very sensitive to MSG food additive. But I doubt it would affect the motor actions of fingers like you describe.

People do develop compression at the elbow. But that would not really link to your blue toe episodes. Sometimes a journal clarifies things.

My son just had surgery to release the compression at the elbow, his was caused by a car accident and caused the numbness in the last two fingers that you described. The surgery was successful.
I have the same symptom, as well as numbness and weakness in my hands and fingers and an inability to straighten my arm in the morning, but mine is related to the hereditary neuropathy and is not treatable by surgery. I was tested for HNPP, but it was negative, so you can have nerve compressions with CMT, not just HNPP. My EMG at Johns Hopkins showed pinched nerves at wrists, elbows, and the neuro was pretty certain there would be others, which is why he tested for HNPP.
It can be a very complicated process to find a diagnosis, and many seemingly unrelated symptoms can be part of the same disease, then again perhaps your nerve compressions could be treated by surgery and your toes are related to a circulatory problem. There is a test they can do to find out ow the blood flow is to your feet, it involves tiny blood pressure cuffs for each toe.
Age and activity level are not a guarantee against circulatory problems. Does hair grow on your toes? I remember being shocked when my podiatrist remarked on this, but it does give some indication of the state of your circulation.
I hope that you get some answers soon.

I would like to add:

I think it would be a good test to soak those feet in epsom salts baths twice a day in luke warm water for about 30minutes.

The magnesium in them gets thru the skin and opens up small blood vessels that may be spasmed shut. Magnesium relaxes muscles and calcium contracts them. So when magnesium is low or can't get to the peripheral parts of the body, circulation appears poor. This test is easy, and inexpensive and can reveal alot for some people.

If this works, then you can move up to a good oral version in time.

Yes, no hair on my toes or on my calves. Always had plenty. Now I don't have to shave my legs. I'd rather have hair on my legs and not have CMT though.

Fortunately or unfortunately, I am plenty hairy on my toes.

But you're right... it could be all related to one thing -- or several issues. Or it could be a non-issue and just some quirk. I can live with numbness and blue toes. I do want to rule out scary things like MS and spinal tumors so will go back to the neurologist who was going to order a cervical MRI. After that, I think I'll just wait and see. I figure it'll either go away, or it will stay the same, or it'll get worse and some new weird symptom will come up which will make everything obvious.

Anyway, thank you for your advice! I'll come back and post if the numbness is ever figured out.

Returning to report that I had a normal cervical spine MRI. No tumor, sign of MS or syrinx or disc injury.

I have since noticed weakness and achiness in my hands and went back to the neurologist who also noted decreased sensation in my feet as well as decreased temperature sensation (which I had noticed too). I feel like I'm not sure what's normal any more. Is that hot? Does that hurt? Is that normal? I don't know! Anyway, he said it looked like a small fiber sensory neuropathy and we've got a plan to rule out lots of systemic issues with various blood tests and hopefully something will come up. Or maybe, hopefully nothing will come up. Regardless... we've got a plan.

The weakness is kind of surprising to me and I've noticed it when trying to use scissors or tweezers or carry something or unscrew jars (which I used to pride myself on doing). I'm still able to do the task, but I get tired easily or I have to adjust my grip and try it differently.

Anyway, because it's the numbness and weakness is a constant issue, it's hard to ignore, so I'm looking forward to the results of the blood tests.