Here is My Question:
Hello (again)- I just submitted a question regarding T1D and MS symptoms of foot cramping/numbness. I forgot to add that I have had T1D for 49 years- with reasonable glucose control- I wear a pump/cgm. The MS was formally diagnosed 10 years ago, but I may have actually had it starting since the age of 18. I am now almost 60. Only took Tecfidera briefly as it caused hypoglycemia. No changes on MRIs done yearly and to this point no severe disabling- only intermittent numbness/pain/fatigue.
I am wondering how best to have work up done to evaluate MS vs T1D neuropathy vs sacral lumbar issue...Thanks so much for your insights.
It should be fairly easy to differentiate MS related sensory symptoms from diabetic neuropathy or lumbosacral polyradiculopathies (Lumbar canal stenosis, for instance). Remember, Multiple Sclerosis does not affect the peripheral nervous system which is the source of symptoms in people with either diabetic neuropathy or lumbosacral nerve root compression or injury. Peripheral nerve disease or injury can be evaluated with nerve conduction studies and electromyography, a procedure commonly performed by neurologists specializing in neuromuscular disease. The next step would be to see this type of specialist.
Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego
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