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Author Topic: What causes generalized numbness and poor balance?  (Read 3635 times)

Offline Pmb

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A friend of mine tells me that he has generalized numbness (proabably involving a lot of neuropathy) which has affected their balance and sensation in the lower half of my body. Brigham and Women's hospital had no idea what was wrong and sent him home.

If you were him what would be your next step in finding out what the problem is? I.e. what kind of doctor would yo go to?
« Last Edit: 21/10/2013 23:41:45 by chris »


 

Offline Supercryptid

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Re: generalized numbness
« Reply #1 on: 21/10/2013 06:15:27 »
Did they actually run any tests at the hospital?
 

Offline CliffordK

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Re: generalized numbness
« Reply #2 on: 21/10/2013 07:43:11 »
Is it one side of the body or both sides of the body?  Where does the numbness start?
Age?
Why did they send him home?  Did the numbness get better?

Weakness?  Reflexes?

Swelling or discoloration in the legs?

What tests were run?
Spinal CT?
Spinal MRI?
« Last Edit: 21/10/2013 08:02:35 by CliffordK »
 

Offline Pmb

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Re: generalized numbness
« Reply #3 on: 21/10/2013 08:38:54 »
Quote from: Supercryptid
Did they actually run any tests at the hospital?
Yes. Five MR's ,an MRA,and an MRi with Catscan. I assume they showed nothing since he told me they had no clue what was going on.


Quote from: CliffordK
Is it one side of the body or both sides of the body?  Where does the numbness start?
I'll get back to you when I find out.

Quote from: CliffordK
Age?
70's

Quote from: CliffordK
Why did they send him home?
Because they couldn't figure out what was wrong. No hospital will admit a patient unless they're recovering from surgery or at high risk of dying.

Quote from: CliffordK
Did the numbness get better?
No.

Quote from: CliffordK
Weakness?  Reflexes? Swelling or discoloration in the legs? What tests were run?
Spinal CT?
Spinal MRI?
I'll find out and let you know.
 

Offline RD

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Re: generalized numbness
« Reply #4 on: 21/10/2013 09:15:50 »
A friend of mine tells me that he has generalized numbness (proabably involving a lot of neuropathy) which has affected their balance and sensation in the lower half of my body.

Something compressing the spinal cord could be responsible [ Spinal stenosis ]
By " affected their balance" they may mean impaired proprioception, (via spinal cord compression),  rather than the inner ear being involved.

If you were him what would be your next step in finding out what the problem is? I.e. what kind of doctor would yo go to?

A neurologist to identify where the nerve damage has occurred.
« Last Edit: 21/10/2013 10:03:43 by RD »
 

Offline CliffordK

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Re: generalized numbness
« Reply #5 on: 21/10/2013 10:38:04 »
A lot would depend on the physical exam.
Spinal problems would be high up on the differential. 
Sciatica.
Spinal Stenosis.
Even Prostate Cancer.

If it is bilateral, it could indicate something in the spine, whereas unilateral could either be where a nerve exits the spine, or something in a leg, or perhaps in the brain.

Could  a stroke present as localized numbness?

DIABETES

Circulatory problems.  Low blood pressure, high blood pressure, orthostatic hypotension.

It would be good to know any preexisting underlying conditions that might be related.

It is, of course, possible to have multiple unrelated issues, especially in a 70 yr old.  And, thus, one might also wish to know about preexisting conditions.  For example, benign positional vertigo could be overlaid on other issues.

Quote from: RD link=topic=49354.msg421843#msg421843
A neurologist to identify where the nerve damage has occurred.

Yes, a good start. 
A neurologist should at least give a very good quality, very specific physical exam, which would then help determine what is next.
 

Offline Pmb

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Re: generalized numbness
« Reply #6 on: 21/10/2013 14:05:56 »
The GP and Brigham's has given up so it can't be that simple. I'm certain they've thought of all of those things.

I was really looking of the next step, not a diagnosis. I don't think forums are a good place to go to discuss a diagnosis.

I've decided that the best next step is a discussion group on this subject. That way there just might be someone reading/posting who had the same thing or heard about it.

Thank all of you.
 

Offline CliffordK

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Re: What causes generalized numbness and poor balance?
« Reply #7 on: 22/10/2013 00:24:32 »
First make sure the other doctors have truly "given up", rather than just determining the cause, and that they thought it would either improve with time, was incurable, inoperable, or the patient was a poor candidate for surgery, or the risk from the "cure" was greater than the disease.  Or, perhaps they are in the process of further analysis.

Then ask the GP to schedule a neuro consult, or perhaps a neurosurgical consult.

It never hurts to ask for a second opinion. 

Back surgery, of course, can be life saving with certain types of pinched nerves, but also is not always curative, and carries significant risk.
 

Offline cheryl j

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Re: What causes generalized numbness and poor balance?
« Reply #8 on: 22/10/2013 01:11:44 »
Just an observation or opinion, but one thing health care professionals don't always admit to is the difficulty of diagnosing something in the earliest stages when symptoms are vague and abnormalities may not even show up on show up on scans. I don't know how many times I've been told "if it doesn't get better in a few weeks, come back." Often it did get better. Viral infection? An injury that healed? Who knows. Occasionally it got worse and they figured out the cause.  But the squeaky wheel gets the grease, so if it doesn't go away, he needs to go back to ER or his family doc and ask for a referral to a neurologist.
 

Offline Pmb

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Re: What causes generalized numbness and poor balance?
« Reply #9 on: 22/10/2013 01:47:17 »
Quote from: CliffordK
First make sure the other doctors have truly "given up", rather than just determining the cause, and that they thought it would either improve with time, was incurable, inoperable, or the patient was a poor candidate for surgery, or the risk from the "cure" was greater than the disease.  Or, perhaps they are in the process of further analysis.

Then ask the GP to schedule a neuro consult, or perhaps a neurosurgical consult.

It never hurts to ask for a second opinion. 

Back surgery, of course, can be life saving with certain types of pinched nerves, but also is not always curative, and carries significant risk.
My friend is one of the most intelligent people I know and as such has already done all that. I'd have also done all that before I'd ask such a question as this. He's already seen a neurologist. Two of them I recall. In fact the one he saw works with the neuro surgeon who did the brain surgery on Michael J. Fox.
 

Offline cheryl j

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Re: What causes generalized numbness and poor balance?
« Reply #10 on: 22/10/2013 03:51:35 »
http://www.todaysgeriatricmedicine.com/archive/070912p14.shtml

From the sounds of the article above, diagnosing neuropathies can be like looking for a needle in a haystack. A lot of neuropathies are vascular. When age or conditions like diabetes damage capillaries, they damage the nerves those tiny capillaries supply. I don't know if that shows up on a cat scan or MRI.

Here's also a Medscape article. You might have to register to read it.
http://www.medscape.com/viewarticle/510706_1
« Last Edit: 22/10/2013 04:04:49 by cheryl j »
 

Offline Pmb

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Re: What causes generalized numbness and poor balance?
« Reply #11 on: 22/10/2013 04:37:30 »
http://www.todaysgeriatricmedicine.com/archive/070912p14.shtml

From the sounds of the article above, diagnosing neuropathies can be like looking for a needle in a haystack. A lot of neuropathies are vascular. When age or conditions like diabetes damage capillaries, they damage the nerves those tiny capillaries supply. I don't know if that shows up on a cat scan or MRI.

Here's also a Medscape article. You might have to register to read it.
http://www.medscape.com/viewarticle/510706_1

This is wonderful, Cheryl. You are truly a gem! Thanks!
 

Offline healthresearch

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Re: What causes generalized numbness and poor balance?
« Reply #12 on: 04/11/2013 18:39:29 »
A doctor to see when having numbness is either a neurologist or orthopedician.

First, knowing the exact pattern of numbness would help a lot, for example:
  • Numbness in both legs speaks for a disorder in the lumbar spine
  • Numbness in both arms and legs speaks for the stenosis of the cervical spine or, when only feet and hands are affected, for peripheral neuropathy that can be due to newbielink:http://www.hxbenefit.com/causes-of-numbness-and-tingling-paresthesia-in-fingertips.html#peripheral-neuropathy-polyneuropathy [nonactive], including diabetes, certain drugs, vitamin deficiencies, etc. Bilateral, but nonsymmetrical numbness can slowly develop in atherosclerosis...
  • Numbness on one side of the body (left or right) speaks for a brain disorder
  • Numbness that moves may occur in multiple sclerosis
Any associated symptom besides walking imbalance could help to narrow down the causes: pain, bladder or bowel incontinence, dizziness, bluish fingers...
 

Offline Lmnre

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Re: What causes generalized numbness and poor balance?
« Reply #13 on: 06/11/2013 09:30:26 »
Has a neurovascular specialist reviewed the images for stenosis of the vertebrobasilar distribution system?
 

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Re: What causes generalized numbness and poor balance?
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