Small Nerve Neuropathy

Here is My Question:
I have history of Crohn's Disease with multiple surgeries starting about 25 years ago. I developed heavy legs and difficulty walking. Went to Neurologist about 5 years ago, had conduction tests and was told I had small nerve neuropathy. Burning, pins and needles feelings in both feet with many shocks arranging from light to very hard. Fatigue, weakness in arms and legs, vision problems progressing. Having a brain MRI showed one small lesion. Follow-up MRI proved the lesion to be non-specific. Was told its not a tumor, etc. Doctor setting me up with MS Specialist. Does this sound anything like MS or Neuropathy and Lesion from having Crohn's Disease?

Answer:

I am glad you are seeing another neurologist soon since much of the information provided in your question does not make sense. Let me point out the inconsistencies for you:

1.  Small fiber neuropathy causes pain and decreased sensation to hot and cold and pinpricks usually in the feet or distal extremities. Autonomic symptoms are not uncommon as well. It does not cause heaviness or difficulty walking and usually is associated with normal nerve conduction studies.

2. There are many reasons for a patient with inflammatory bowel disease to develop different types of neuropathy. These include the disease itself, drugs used to treat the disease and nutritional deficiencies. A good neurologist should be able to determine if you have a neuropathy and the type. This will help determine the cause of the neuropathy, if indeed you have a neuropathy. 

3. MS doesn’t affect the peripheral nervous system (not in the classical sense) and should be relatively easy to differentiate from a neuropathy

Good luck

Revere (Rip) Kinkel MD
Director of the Multiple Sclerosis Program
Professor of Clinical Neurosciences
University of California San Diego