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Dr. David
Dr. David, Board Certified MD
Category: Neurology
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Experience:  Experienced physician in Neurology
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I have a numb left leg for four days, feels like it is hot,

Customer Question

I have a numb left leg for four days, feels like it is hot, but it is not, numbness in groin area, constant pain in my leg and groin area; and just below the shoulder blade pain, very sesitive to touch - burning sensation. And... the same but stronger on my right chest, very burning sensation, cannot be touched.
Submitted: 2 years ago.
Category: Neurology
Expert:  Dr. Mark replied 2 years ago.

Does this pain and numbness extend into past the knee, down into the lower leg?

 

Did the shoulder blade pains and the leg pains start at the exact same time? Or are they different?

 

 

Customer: replied 2 years ago.

yes, the pain and numbness extend to my foot.

below shoulder blade the pain started at the same time, and extremely burning sensation on the right chest. Everything at the same time - 4 days ago.

Expert:  Dr. Mark replied 2 years ago.

OK.

 

Well, it certainly is a bit unusual for these to happen at the same exact time.

 

This appears to be two separate issue with nerves -- one potentially in the neck area, and the other in the lower back area.

 

"Pinching" of a cervical (neck) nerve at the C6 level can cause upper chest and shoulder blade burning (as well as symptoms that run into the forearm and hand).

 

"Pinching" of a lower lumbar nerve, either L5 or S1, can cause pain that radiates down from the back to the foot.

 

So - I can't fully explain why this may have happened at the exact same time in two different places. It is very rare that someone has a stroke in a very specific area in the brain that causes only one sided pain (which does not seem to be the case here either).

 

I would discuss this with your doctor to see if some steroids or pain medications can be prescribed to you, and to undergo an exam, to see if imaging (like a MRI) should be ordered for you.

Customer: replied 2 years ago.
went to a doctor today. oversensitive nerve: t-12 and l-1. all responses slower.
Customer: replied 2 years ago.
and this is chest and lower chest, not upper chest; and right below the scapula.
Customer: replied 2 years ago.
and as i indicated, it is a left leg, and the right sight of the torso.
Expert:  Dr. Mark replied 2 years ago.

I'm not sure that is quite correct.

 

Pain that radiates down the leg to the foot would be either L5 or S1. T12 and L1 would stay in the lower back area, and could radiate toward the front above the groin, but not down the leg at all.

 

And it certainly wouldn't explain the shoulder blade or chest wall pain. The scapula could be an issue with cervical nerve roots. The lower chest would tend to be more of thoracic nerves. Hopefully they also ruled out other potential causes for chest pain as well.

 

 

Customer: replied 2 years ago.
it is not a chest pain, it is superficial, extreme sensitivity to touch, feels like burning - that is the right chest; just pain and sensitivity to touch below the right scapula; and numbness of left leg with pain, partial numbness to the groin area. Everything at the same time and it is slightly worse after 4 days.
Expert:  Dr. Mark replied 2 years ago.

This sensitivity to touch -- hyperesthesias - is often nerve related.

 

Why it is occurring in many different places at the same time is hard to know.

Customer: replied 2 years ago.

whould you rule out a spinal tumor? or what potential diagnosis would you suggest? however, is kind of a sudden onset.

Expert:  Dr. Mark replied 2 years ago.

Well, spinal tumor is unlikely just due to the specific areas that are involved, and as you say -- sudden onset. It would also generally cause symptoms more in a "cape" like distribution, not so specific as you mention.

 

I would look for issues which could irritate nerves.

 

I would start with getting evaluated by a neurologist, if this persists.

 

They can do detailed neurologic testing to see where the issue may lie.

 

Based on this, testing can be ordered. It would seem that MRI imaging of the spine can be done to rule out issues which could cause radiculopathies (nerve root irritations). Other issues are polyneuropathies, which can be caused by many different potential issues, such as toxins, such as some medications, inflammatory processes. Testing with EMG can be helpful if this persists for more than several weeks, as that would be able to see if there is potential nerve issues/ injury developing.

 

 

Customer: replied 2 years ago.

they have done evoked potential today - both sides are normal.

radiculopathies from T to L? All the way down? What can possibly cause that?

The only medication I am taking is Crestor.

Any comments?

Expert:  Dr. Mark replied 2 years ago.

If you've only had symptoms for four days -- it probably is too early for any changes to show up. Several weeks, and you could get a more accurate testing.

 

Radiculopathies all the way down would be unusual. But that is not your case. You seem to describe two or three distinct areas of pain.

 

The crestor wouldn't be associated with this kind of thing typically.

 

I think you need to be evaluated by a neurologist in person.

Customer: replied 2 years ago.

i am sorry for addtional questions, but what about the leg? it is numb with associated pain, cannot walk fast, started kind of dragging it.

how would you put these three together? and please trust me it happened at the same time.

Expert:  Dr. Mark replied 2 years ago.

The type of pain you are having in the leg, with symptoms all the way down, with weakness, and numbness really sound like some type of neuropathy. The symptoms down the front of the thigh could be femoral neuropathy. The symptoms down the back of the thigh could be sciatic nerve related.

 

To put all three together at the same time is difficult, because this is not a usual occurence, and I would want to get further imaging to help with the diagnosis.

Customer: replied 2 years ago.
For your information, a lesion has been found on the level of Th4 - MRI
Expert:  Dr. Mark replied 2 years ago.
A lesion was found within the spinal cord at T4? Or the vertebral body at T4?
Customer: replied 2 years ago.
al the symptomos were typical for acute transverse myelitis - and this is the final diagnosis a of now
Expert:  Camille-Mod replied 2 years ago.

Hi, I am a Moderator with Just Answer, when your Expert comes back on line he will see your response and will return to assist you. If I can help further, please let me know. Thank you for your continued patience:-)

Expert:  Dr. David replied 2 years ago.
this is Dr. David

if the MRI scan did not see a spinal tumor, then there is no spinal tumor causing your symptoms.

sounds like you are having parasthesias in the left leg. one thing which should be checked for is a blood lot in the leg which might cause your symtpoms. also an MRI of the pelvis must be done to look for lesions in the sacrum and pelvis which could be causing your symtpoms as well.
Customer: replied 2 years ago.

Hello David,

As per my previos e-mail, yes, there is a lesion in the spinal cord (clearly visible on MRI), whether is it tumor or not, it cannot be conclusively dignosed only by viewing MRI scan. Right now, the neurological diagnosis is Acute Transverse Myelitis.

Expert:  Dr. David replied 2 years ago.
I see

thank you for that clarification.

these spinal cord tumors are very hard to biopsy since they are sometimes in the spinal cord itself. when the lesion is in the spinal cord itself, we call it an intramedullary lesion. whatever it is, it seems to be taking away your legs and your senstation.

once thing which should be done is to give radiation therapy to the spinal cord lesion at T4. if it is a cancer in the spinal cord, the radiation will shrink the tumor and decrease pressure off of the spinal cord nerves. if it is not a cancer, then nothing is really lost.

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