How does neuropathy first present itself?

[Dignan]

I've heard of neuropathy from long term use of seizure drugs. But, sometimes I do get paranoid about it when I feel my foot go numb for a time. It always has come back around, but it reminds me of what it must be like to have to deal with neuropathy. Just today I was sitting at a restaurant in a booth with my foot bent and heel off the ground, and when I stood up my toes were numb and it took awhile for them to come back.

I wondered if anyone with experience could say if true neuropathy is the sort of thing that comes on gradually, coming and going like a foot being asleep, or if it is more pronounced/distinctive and therefore not easily confused with something as common as a foot falling asleep or periodic hand numbness from working, etc?

Just wanted to know what the early signs would be and how or if they would be different.

 

[Tez_20]

Hello Dignan,
I was tested twice in my early 20s for confirmation on nerve damage neuropathy and it's annoying at times with loss of sensation which your having in your feet besides fingers and suffering with Raynauds ontop...I have to type in gloves to help my fingers.
Mine came on gradually concerning my fingers and I find it can be painful at times also..i'm adding a link below on the condition and I hope it helps

http://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/basics/definition/con-20019948

 

[Dignan]

Thanks for the link, and I'm sorry for your troubles you've had.


I checked out the link and just mentioned numbness and tingling as early symptoms, but I was wondering how that first manifested itself. Was it sometimes numb and sometimes normal? Was it pretty much all the time? Painful? Similar to a foot in the wrong position and falling asleep or different?

 

[Cint]

Dignan,

Along with E, I have Type 1 Diabetes, so neuropathy is very common. I've had Diabetes for 10 years now and am now starting to experience the neuropathy in my feet. I have to keep slippers on at home, otherwise it feels like I'm walking on a thin layer of very hot water. A burning sensation. It's all the time now for me and worse when I first get up in the morning. Some days it is painful. It first starts out as a burning sensation, or like someone is sticking pins in my feet.

 

[Dignan]

I hate to hear you are dealing with that Cint. I've just been wondering about it more as lately, I've notice that my toes become numb. No burning or anything like that, but especially during a workout (riding a recumbent bike) and sometimes afterwards, I'll notice the numbness.

Also, I've noticed it after sitting with my foot bent for awhile. I can usually wiggle the toes and get it to go away, but sometimes a slight tingly feeling can remain for awhile afterwards. I didn't know if this was just normal type stuff, or if it could be early onset neuropathy after years of taking AEDs.

Based on your experiences, it doesn't sound like my issue is anything serious though.. but I just wanted to check.

 

[masterjen]

Sounds more like pinched nerves or poor circulation when you mention the association with a bent foot and a work-out. Wiggling the toes improves circulation, and the tingling that follows is caused by either better blood circulation or relieving the pressure on a pinched nerve. I don't know if you're overweight or not, but sensations of numbness during exercise can be a sign of cardiovascular or peripheral vascular problems. Wiggling the toes, or any part of the body, does not get rid of neuropathy. Neuropathy is a chronic condition.

 

[Dignan]

Jen,

I'm not overweight, and I work out 3 to 5 days a week. I usually run and do weights, but due to a strain achilles, I've been doing recumbent bike instead the last few weeks. My job requires that I sit alot, and if I sit with my foot bent under the chair I notice the numbness. Also, the toes will go numb midway thru the biking exercise sessions, which seems odd for circulation issues since the blood is really pumping then. I also have no pinched nerve (that I am aware of at least).Sometimes, I wonder if I feel the slight tingling in my toes while lying in bed, but I admit, it may be in my head at this point with regard to that.

I didn't mean to suggest that wiggling toes would cause neuopathy to go away, I just wondered if it might bring temporary relief. Please let me know if that wouldn't occur, even temporarily, and then I guess I can say that it is not neuropathy, but given my level of fitness I would be surprised (though i realize not impossible) if it was poor circulation. My cholesterol and BP numbers are always very good, and my doc says I am low risk for heart problems.

Thanks for any advice or thoughts you may be able to share.

 

[masterjen]

Hi, Dignan
Nice to read that you are into working out also! I do have peripheral neuropathy, and in the early stages I noticed it in my toes - I could not tell if water was hot or cold and when drying the shin part on one of my lower legs I would have a pins and needles sensation. I thought these things were "funny", and wasn't concerned about it. This was in my 30s well before I even started having seizures, so I cannot blame medication. Over time the neuropathy has progressed, and despite numerous tests so far a reason has not been identified.
I would suggest keeping a close eye on your symptoms. Watch for progression of this numbness/tingling/etc. traveling into your lower legs and/or affecting your fingertips and fingers. If you notice any progression, ask your neurologist for an EMG. An EMG unfortunately does not diagnose a cause for a nerve problem, but it will establish a baseline, and determine if there is any pathology in nerve transmission.

 

[Nakamova]

When I was on Dilantin my neuro would test for neuropathy using the tuning fork test. (This more-or-less involves applying the tuning fork on the big toe, and then asking the patient when they sense the vibrations starting and stopping.) It's a fairly simple test, but it's a good way to set a baseline response and then evaluate whether sensitivity has changed over time. You could ask your neuro to do the test at each appointment.

I have occasional numbness or pins and needles in my toes and fingers, but I think it's just due to circulation or positional issues mentioned above. You can be fit and still have them

 

[Dignan]

Jen and Nak,

Thanks so much for the info on your experiences. I do sometimes think I am feeling it a little in my pinky fingers too. I'll be sure and mention it to my neuro when I see him next month.

Nak, I dont think my neuro has done the tuning fork before, rather he has just moved a metal wand under my foot and asked if I feel it or not. I'll ask him about the tuning fork.

It seems strange that circulation issues might crop up for people that do alot of cardio work, but maybe that comes with age or perhaps seizure drugs or who knows. Maybe you guys know more about that than me.

Also, I know that the keppra I take has made me feel physically weak and fatigued, and I work out alot to try and counteract all of that. Don't know if that is relevant, either from a med standpoint, or from maybe working out too much..?

 

[Janus]

Dignan, I know we talked a bit about this issue, but now that i read that post of yours I am reminded of my want to work out to keep strong. I am very active and exercise every day. But the weight training, even a little counteracts natural decay of muscle that happens to everyone. It happens pretty rapidly to those of us in the 40's age. So, let us know what you find-out/experience.

 

[Dignan]

So, is it safe and beneficial to continue with normal workouts despite numbness and tingling, whether it is related to neuropathy or otherwise?

I would assume so because exercise seems to help everything for me, but I've still been feeling the numbness and I wonder if I'm doing something by working out so much to make it worse.

When my hands, actually thumb and fingers feel that way, it feels as though my forearms and hands are tight as well, like after a workout. I wonder if I've just overdone it, or if this is something to actually be concerned about. I almost want to say its like light carpal tunnel in the hands, but it is going on in the toes some too, and today I could have sworn I noticed tingling in my lower lip (though that didn't last but a few minutes at the time).

I've called my GP's office but they havent called me back, and at this point I dont know that they will because of the weekend. I'm already scheduled to see my neuro in a few weeks.

I guess I'll continue working out, but it seems strange that I've noticed these sensations more coinciding with the amount of time I've been riding the recumbent bike instead of running. I wonder if all that sitting, plus my work sitting, plus my weight work has aggravated a nerve or something in both my lower and upper back...?

I may be beginning to overanalyze (as I am prone to do), so tell me to rein it in if I am sounding crazy..

Update: Just heard from my GP's nurse and she is telling me it is likely nothing and just to not workout for a few days (even though this has been going on a few weeks now) and see if I feel better. Man, I hate not working out though..

 

[valeriedl]

Sounds more like pinched nerves or poor circulation when you mention the association with a bent foot and a work-out. Wiggling the toes improves circulation, and the tingling that follows is caused by either better blood circulation or relieving the pressure on a pinched nerve. I don't know if you're overweight or not, but sensations of numbness during exercise can be a sign of cardiovascular or peripheral vascular problems. Wiggling the toes, or any part of the body, does not get rid of neuropathy. Neuropathy is a chronic condition.

I had herniated discs, almost bone on bone so it was pinching the nerves pretty bad, and I was having the same problem with my feet. It started out with numbness then turned into pain through the years. I had it in my calf too. I had to have screws put in my back and it went away.

It's starting to come back again and I'm seeing the dr next week for it. I'm hoping I don't have to have surgery again.