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You can have flat feet, normal feet or high arches. You can have hammertoes but not all do. I do not. Hammertoes, drop foot, etc. can be caused by a lot of things. Many in the general public have one or the other. Also, I have normal looking feet. Not everyone has drop foot either. Or it may not be that bad if they do have it. Hands and arms can be impacted as well. Mine at this point are not but time will tell. The rest of the family going way back does have both hand, arm, leg and foot issues/weakness. CMT progresses no matter what you do. CMT does not come on just like that and all of a sudden there you are. But CMT does progress. I have known about CMT since I was five years old. I have kept up with all the research that is being done - and there is lots - for many years now. And much was before the Internet. This information is all from reputable resources. As far as EMG/NCV testing they can tell the type via the testing. When the myelin is damaged (CMT type 1), the nerve impulses are conducted more slowly than normal. If the axon itself is damaged (CMT type 2), the speed of nerve conduction is almost normal, but the strength of the signal is reduced. CMT is a multi-gene disorder and so there are many different defective genes which cause the disorder. CMT affects the peripheral nervous system (PNS) and therefore it results in both motor symptoms (weakness and muscle wasting) and sensory symptoms (numbness). CMT is progressive no matter what you do. A neurologist who is an expert in CMT would be the doctor to see. I cannot say that you have CMT. Only a good neurologist can help you there. You certainly do have something going on. Hope you get to the bottom of it. |
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It will set in at other times during the day if I'm stationary too long. Again, moving stops it. For whatever reason, getting my motor nerves active will settle down this sensory problem. |
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I did not by any means mean to come across as insinuating you didn't have CMT. I am sorry. I know you do! I was just stating that I am absolutely un-educated in CMT and most other neurological disorders because this is all very new to me. I just wanted to get the point across that reading things purely online or googling symptoms can be misleading for someone like myself that has not been researching or dealing with this for several years. I have by far gained the most experience and education from this forum, from people like yourself. And I am so grateful there is a forum like this available for people suffering from neuro symptoms and not knowing what the heck to do about it. I know that no one on here can dx anyone, but the support def. helps me and I know so many others like me!! Thanks for educating me in CMT and supporting me in finding some answers :) |
Emily, with your symptoms I would expect an abnormal EMG/NCS. Once you have numbness in your feet and lower legs it will probably show up on a skin biopsy as well.
Some of my symptoms were gradual and ignored as just being clumsy, lazy, etc. I had a dysfunctional family situation which complicated things, it was in no one's interest to diagnose me with a genetic disease since I was the product of an adulterous relationship. I did develop hand and arm weakness very suddenly about 8 or 9 years ago. I couldn't hold plates either, and couldn't take wash out of the washer, carry groceries, etc. it was diagnosed after an EMG as carpal tunnel, but this was later found to be incorrect as it was a flare up of the CMT. It is usually gradual but there can be exceptions. Everyone is very different with this disease as Kitt said and anything you read will probably make unwarranted generalizations. It used to be thought that pain was uncommon with CMT. This has been disproved and my pain is quite severe, but many sites repeat outdated information, even the Mayo site has lots of inaccuracies. Physical therapy gave me back a lot of strength in my hands at that time. Later I lost range of motion in one arm such that I couldn't dress myself, again therapy helped. Last year I sprained my ankle and physical therapy allowed me to continue driving a little, I have virtually no motion in my ankles now, but can drive for about five minutes which takes me to the doctor, dentist, and food store. The doctor should be very interested in your family history, if they aren't diabetic this must have a hereditary component. Your symptoms are perfectly consistent and should be taken seriously. It took my podiatrist to actually get the ball rolling. He refused to treat me again after I went to him with a foot infection ( he did treat the infection ) until I saw a neurologist. He said I had the worst neuropathy he had ever seen and that bilateral neuropathy in both hands and legs wasn't simply carpal tunnel, especially with my other symptoms - high arches, tight Achilles' tendons, poor gait and balance, etc.. He thought that my height (6'2") made it all worse since it is length dependent. Another thing that caused a sudden worsening of my symptoms was Tricor, a medication I was given for extremely high tryglerides. It quickly exacerbated my balance issues to the point that I could no longer walk without falling. I improved as soon as I stopped it on my neurologist's hint. They should try to find out if there is a treatable cause for your symptoms, but CMT is progressive and incurable. My neurologists both said "good-bye and good luck." Chronic disease makes doctors uncomfortable. It is a relief to have a diagnosis and the progression is usually slow, but it is a big thing to accept, especially at your age. I hope they can help you. I was extremely flexible when I was younger, except that the muscles in back of my legs were always tight, and so is my one son, although less so than he used to be. I have read of other CMTers with this trait. |
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Rarely would anyone have a perceived weakness rather than one that is there. You have gone from automatically writing etc., to having problems writing. A suggestion is to try to be as calm as possible during the neuro exam. Save your questions until the end and hopefully the neurologist will answer them. A neurological exam is very thorough and will feel like you have really been examined. And stress does not help, but RARELY causes the sensory symptoms. Unfortunately, my husband had to say, "I have known my wife for 20+ years and she has changed." Finally that helped with doctors starting listening. I had to act like I was not really hurting when I was so scared and in so much pain. Not getting enough sleep did not help either. Oh, and if you are going to a teaching place, find out if someone is an attending/resident/or fellow at the beginning. They are supposed to tell you that, but don't always. You might be able to ascertain that from the provider's web site. This is particularly important if they come in alone and then bring in someone else. Part of your story will be wrong, deleted, or confused with dates and or symptoms. I am really hoping that you will be heard and that the neurologist you see will be professional.:hug: Godspeed. |
Emily if this has only been going on for 8 months it is possible that there might not be enough damage yet to show up on an EMG/NCS. Just to prepare you in case. this doesnt mean the symptoms arent real or caused by stress. It also doesnt mean that your pain or symptoms arent proportional to the damage you do have. It just means that an EMG/NCS does not have the sensitivity to detect below certain levels of damage. If damage to the axon or myelin sheath is detected by an EMG/NCS it may be categorized early on as mild or mild to moderate. Again this doesnt mean it isnt painful or debilitating.
I started out in October 2001 with symptoms but didnt have an EMG/NCS until October of 2003. By that time my PN was moderate to severe already. I was exposed to high levels of toxins for an extended period of time so no surprise there. Even if your emg/ncs comes back negative now, it could turn to positive in just a few short months. I hope this helps. |
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