Hello all,

I'm at a bit of a loss. About 2 months ago I woke up one morning and my entire left side was numb and tingly. It came out of nowhere. Later on I started getting some tingling in my face and shortly after it spread everywhere. Now it is completely random depending on the day. The most common thing is tingling in my left leg from my knee down to my foot. But, both arms and legs have had both numbness and tingling at some point. The numbness is more common in my arms while the tingling is most common in my feet. The burning is more common when I'm indoors and the AC is running but after laying in bed for a while it eventually goes away. They do feel cold to touch. Sometimes my hands will be similar but not nearly as bad. There really is no rhyme or reason to where the symptoms are honestly. They tend to not be as noticeable if I'm active like doing work around the house or in the gym. When I'm sitting it's far more noticeable. I've been to the ER twice first the only thing they found was low potassium. The second time I got dizzy and lightheaded while driving and went in but I ended up testing positive for covid 2 days later and the dizziness is mostly gone a few weeks later.

So far I've had a ton of bloodwork done and a brain MRI and everything has come back clean. No diabetes, liver and kidney function are normal, no inflammatory markers or abnormal proteins. Things like B1/12, thiamine, etc. have all been checked and they are high but I have started supplementing more consistently lately so they might be artificially elevated. Only thing is my blood pressure has been slightly high for a few years now but not high enough to take medicine for according to my dr. Plus with no drinking right now it should lower to a normal level but the anxiety isn't helping that. My EMG is scheduled this month so that should tell me more. But in the meantime any ideas what this could be? I've asked both my PCP and a neurologist that I had an initial appointment with and they are both unsure. They don't think it's from my drinking but it could be possible. For the past 10 years I've probably averaged around 15 drinks spread over 1-3 days on the weekend. It could be anywhere from 2 beers 1 day only to ~20 drinks spread over 3-4 days. It's higher than I should be drinking but from what I've read people have drank far more than that before they got any damage from alcohol. Plus, my bloodwork has never shown any issues. Here is what the neurologist said after my appointment. He did mention that he was encouraged by the exam so it appears that went well. No strength or weakness issues and everything appeared mostly normal.

Differential diagnosis include electrolyte, metabolic abnormalities, increased alcohol intake related symptoms, nonspecific paresthesias, neuropathy, nerve injury. Central nervous system process such as MS or demyelinating disorder cannot be ruled out, especially given it does have relapsing and remitting type of symptom pattern .

Any ideas? Alcohol is the only thing I can think of but the way the symptoms came on make no sense. Usually they would start in the feet and work up not on one side and spread rapidly from there despite stopping alcohol. Plus I stopped entirely drinking 2 months ago except last month I had a bit over a weekend. Nothing since. I have another appointment once my EMG is done but that's a month+ away and the anxiety is driving me crazy. Thankfully I've learned how to keep it under control enough to not go back to the ER because the anxiety is messing with me too badly.

Here's my neuro exam notes if it helps:

Vital Signs:
BP (!) 144/97 (BP Location: Left arm, Patient Position: Sitting, BP Cuff Size: Adult) Comment: 2nd reading | Pulse 81 | Temp 36.6 °C (97.8 °F) (Temporal) | Resp 18 | Ht 188 cm (6' 2") | Wt 86.2 kg (190 lb) | BMI 24.39 kg/m² | Pain Score: 0-No pain

Neurologic Exam

Mental Status
Oriented to person, place, and time.
Level of consciousness: alert
Knowledge: good.

Cranial Nerves
Cranial nerves II through XII intact.

Motor Exam
Muscle bulk: normal
Overall muscle tone: normal

Strength
Strength 5/5 throughout.

Sensory Exam
Light touch normal.
Vibration normal.
Pinprick normal.

Specifically no abnormalities in sensory modalities. He does report feeling tingling in the left lateral leg above the ankle and going down to his dorsal aspect of the foot. However no deficits when touching the leg.

Gait, Coordination, and Reflexes

Gait
Gait: normal (Arises from chair unaided. Good cadence, normal stride length. Narrow base. Normal arm swing bialaterally.)

Coordination
Romberg: negative
Finger to nose coordination: normal
Heel to shin coordination: normal
Tandem walking coordination: normal

Tremor
Resting tremor: absent
Intention tremor: absent
Action tremor: absent

Reflexes
Reflexes 2+ except as noted.
Right brachioradialis: 0
Left brachioradialis: 0
Right biceps: 1+
Left biceps: 1+
Right triceps: 1+
Left triceps: 1+
Right patellar: 0
Left patellar: 0
Right plantar: normal
Left plantar: normal
Right ankle clonus: absent
Left pendular knee jerk: absent