I get movements in feet and tingling before I fall asleep. Is it Parkinson's disease?

Question

Hi doctor,

About 10 months ago after a workout, I had pins and needles on the left side of my body. After months of MRIs and EMGs, I got a skin biopsy that showed you gave small fiber neuropathy. Before I knew this, I got a deep tissue massage and started getting fasciculations. They had calmed down much since October but I will notice them here and there. I always developed movements before I fall asleep. My feet may just move or even my chest, it gives me much anxiety to go to bed. Lately, I have been noticing a little tremor in my right hand and tingling in them when I tried to put in fake eyelashes or hold a pen for a little time. Last week, I have noticed my thumb moved twice. Also, I feel sometimes like my teeth are shaking. A lot or neuros have told me that I am 32 and not to worry about much but they overlooked SFN. I am worried all EMGs are normal. I am concerned now and I have early Parkinson's?

Answer 1

Hello,

Welcome to icliniq.com.

I have studied your data. 10 months ago, I have a sudden onset of tingling on the left side after workout but with normal MRI (magnetic resonance imaging) brain and spine which means the stroke is less likely.

Later you noted random twisting of muscles (fasciculations) with right-hand action tremor occasional. Movements before sleep (hypnogogic periodic limb movements) work up showed SFN but the cause of it not known until now with normal NCV EMG.

We need to find out the cause of SFN like autoimmune disorders etc. It is not Parkinson's syndrome as it is not fitting into it. So do not worry about it. It seems some benign tremor fasciculation syndrome. Please answer some of my questions.

Any family history of similar tremors? Any painful or burning sensation in palm and soles? I want to know about your blood sugar status, thyroid profile, ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), ANA (antinuclear antibody), APLA (antiphospholipid syndrome), ANCA (anti-neutrophil cytoplasmic antibody).

Answer 2

Hello,

Welcome back to icliniq.com.

Yes, APLA is for blood clot and it clogs all type of vessels from capillaries to large vessels. If everything is normal then no need to worry about SFN (small fiber neuropathy). Yes, component of anxiety is there. With peripheral nerve hyperexcitability as fasciculation is not a part of anxiety. But I am reassuring you that this is not Parkinson's symptoms even your aunt had it.

My suggestions are:

1. Do regular mind calming meditation and sleep meditation.

2. You can do short course of Clonazepam for one to two months which will relive your anxiety and movemens both.

Regular follow up with your neurologists. Watch for thinninfg of limbs or reduced strength of limb if you feel it consult neuro again and do EMG or NCV.