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Dr. Sophie :: Medicine & Neurology
Dr. Sophie :: Medicine & Neurology, Doctor
Category: Medical
Satisfied Customers: 2951
Experience:  Neurologist :: Clinical Neurophysiologist :: University of California.
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I have numbness on of the scalp on the right side of my head

Customer Question

I have numbness on of the scalp on the right side of my head and around to the back of the head, also my ear. my head itches and tingles at times like your cheek and jaw coming out of the numbness of having a tooth filled. It is also sensitive when I run my fingures through my hair and catch a tangle like I am ripping out a chunk. The numbness has also gone down my right arm. Again it is only on the skin not the whole arm and it is not on the under side of my arm just the top side. My ear also hurts inside almost like an ear infection but there is no infection. I also have a sorness in the right side of my throat, more like a lump feeling. The numbness also goes down the front of my right leg but doesnt feel as numb as the arm and head. The doctors have no idea what this is. Sent me for MRI of brain and came out normal. My earing is also affect. Cant hear as well but also things are very loud. I have been tested for lupus and have a very low level of non systemic lupus.
Submitted: 4 years ago.
Category: Medical
Expert:  Dr. Sophie :: Medicine & Neurology replied 4 years ago.

Other than brain MRI and a blood test for lupus, has your neurologist done any other tests or considered any other tests?

Customer: replied 4 years ago.
No.
Expert:  Dr. Sophie :: Medicine & Neurology replied 4 years ago.

There is only a handful of conditions that can cause such distribution of neurological symptoms.

Considering your young age, multiple sclerosis is on top of the list and with your "scattered" symptoms in head, arm and leg a brain MRI is not enough.

In addition, MRI may be initially negative in up to 10% of pateints with early MS particulalrly if done without contrast.

You need a cervical and thoracic spine MRI with contrast.

Lupus, if negative, should prompt other autoimmune tests because ANA is not always positive but other more specific tests - SSA and SSB, dsANA could be.

Infectious causes such as West Nile virus, CMV, EBV, etc. can also cause these symptoms.

As important as the MRIs is a spinal tap. They should send your cerebrospinal fluid analysis for oligoclonal bands (MS), immunoglobulin index and viral PCR and routine studies.

Dr. Sophie :: Medicine & Neurology, Doctor
Category: Medical
Satisfied Customers: 2951
Experience: Neurologist :: Clinical Neurophysiologist :: University of California.
Dr. Sophie :: Medicine & Neurology and 4 other Medical Specialists are ready to help you
Customer: replied 4 years ago.
The rhuematologist did the 12 panel test for lupus and showed the low level non systemic lupus and doesnt really think the numbness has anything to do with lupus. Also the brain MRI was done with contrast. Can west nile be a factor when we havent had any mosquitos out yet? Also what is CMV and EBV
Expert:  Dr. Sophie :: Medicine & Neurology replied 4 years ago.

Then your rheumatological tests are sufficient.

It is encouraging that brain MRI w/ contrast was OK although, as I mentioned, brain MRI is not enough and you do need a C- and T-spine as well.

Yes, West Nile is still a possibility even if it not yet "mosquito season" where you live.

Cytomegalovirus and Epstein-Barr virus are common viruses and cause infections like mononucleosis/upper respiratory infections. Sometimes they can affect central nervous system. Another virus that can do that is herpesvirus.

I would definitely do a spinal tap on a patient with your symptoms.




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Dr. Sophie :: Medicine &amp; Neurology
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Neurologist :: Clinical Neurophysiologist :: University of California.