Dear Ask The Doctor: Hi, I am a 30 year old male with crohn's disease and IGA Nephropathy, I had a bowel resection in 2009 to removed the end of my small intestine, and currently taking Azathioprine 150mg per day and B12 injections every 3 months, the IGA Nephropathy is current stable and not causing any problems. recently I have started having muscle twitches all over my body in random places from my face to my toes for about two weeks, also very sensitive skin feelings in various places on my body, this started on my arms, hands , stomach area, chest, upper legs for about a two months, also I have been getting numb dead legs and arms for a few months, and also lightheaded on and off for about a year, I am worring could this be some kind of neurological problem? I do worry about my health a lot and wonder how I will be later on in life. I also take multivitamins and magnesium tablets, I also eat well and healthy. Any advice would be greatly appreciated
Dear Matthew: In my opinion, according to your presenting symptoms, this could be due to peripheral neuropathy. The problem is caused when the peripheral nerves (nerves that carry information and signals to and from the brain) stop functioning properly. There could be many causes of peripheral neuropathy. Autoimmune diseases, chronic kidney diseases, infections, immunosuppressive states, low vitamins (E, B1, B6, B12, and niacin) and toxins could all cause peripheral neuropathy. Due to your history of crohn's disease the most probable cause of peripheral neuropathy in your case could be either low vitamin B12, metronidazole exposure or peripheral neuropathy due to crohn's disease itself. Peripheral neuropathy is one of the most frequently reported neurological complications of Crohn's.
Symptoms due to peripheral depend on the nerve damaged. symptoms may include pain and numbness, tingling sensation, muscular twitching, weakness of the affected muscle, bowel and bladder incontinence, increased sweating and changes in the skin, hair, and nails.The diagnosis of peripheral neuropathy is often difficult and a thorough history, physical and neurological examination along with tests such as CT scan, MRI, Electromyography, Nerve conduction velocity (NCV) tests, nerve and skin biopsy may be required for the diagnosis. Treatment will depend on the underlying cause. Symptoms often can be controlled, and eliminating the causes of specific forms of neuropathy often can prevent new damage. Peripheral neuropathy due to crohn's disease may also require immunotherapy with different agents.