Tingling in Fingers and Toes in a 9 years old girl

Dear Ask The Doctor:  I have a 9 yr old daughter that has been experiencing constant tingling in her toes and fingers for the last 3 to 4 years. We just had an EMG done with the results showing that the large nerve endings were healthy. What else could this be and or what other avenue could we pursue? Please advise.
 

Dear Patient:  Amongst the multiple causes of tingling and numbness of the extremities (hands and feet), there are: vitamin deficiencies (Vitamin B12), nerve compressions at the level of the spine, problems with the peripheral nerves of hands and feet, and metabolic causes as problems with the Thyroid gland and Diabetes. Your physician ruled out peripheral nerves problems in your 9 years old daughter by getting a normal EMG, might be important to rule out vitamin deficiencies, thyroid problems and some other metabolic causes as Diabetes, which can produce the symptoms that you described above.Once all  the important causes are all ruled out we may think about anxiety.

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