I am a 34 year old female. Recently I have been experiencing some uncomfortable symptoms that include:

-Pain ("electrical", burning, shooting or like having needles) in my feet/legs and hands/arms. It fluctuates a lot and goes from one place to another, but it affects mostly my right side.
-Tingling in the same places. Sometimes it is so strong, that it really hurts.
-Alodinia (only from time to time).
-Involuntary muscular spasms. It is not a subjective feeling: you can actually see my fingers or my feet moving. They happen also in my back. Sometimes they are so continous that make the muscle contract for several days.
-Fatigue.
-Dizziness (sometimes strong enough to make me go to ER, where they have found nothing after having done a blood pressure test and a blood test).
-Difficulty grasping things.
-Tremor in hands and legs when I make an effort (usually when I feel worse in general).
-Tremor in head (it shakes mildly when I am semi-relaxed).
-Gait disturbance (when symptoms are at their peak).
-Problems when I urinate: sometimes I cannot keep the bladder shut, so I have a certain degree of incontinence; urge to urinate; other times I find it difficult to empty the bladder, and urine comes out in several steps.
-Pain in the eye.
-Dental pain.
-Nausea (sometimes).
-High sensitivity to temperature changes. Sometimes I feel as if it were too cold but thermometer indicates the contrary. Heat makes symptoms much worse (summer was terrible).


I have had all these symptoms for several months already. First time I experienced tingling in feet and hands was a year and a half ago. It lasted for a couple of months and then went away. Since last autumn, I have been having periodical episodes of severe fatigue, with recoveries in between. In June I had the first episode of involuntary muscular movements, which lasted for three weeks. The worst outburst of the whole thing, with all the symptoms described above, started on the end of July and lasts until today. Some days I feel like I am recovering, and I even think the whole thing is over, but then symptoms appear again and remain there for a couple of weeks.

I suffer from very strong and frequent migraines since 2002. I am now on Topamax, and I have only had three attacks (all of them during the same week) in a month and a half, which is great for me (I used to have more days with migraine attacks than days free of them). I am on Nuvaring (contraceptive vaginal ring) to regulate my menstruations because otherwise my periods last for sixteen days (!!!).

I have had mononucleosis (EBV) in 2001 and chicken pox in 2002. I also have a tiny Rathke cyst (3 mm).

I am an active woman. I exercise regularly, keep a normal body weight and eat healthly. I have a very satisfying professional and personal life.

My GP sent me to the neurologist, after having ruled out himself disorders like lupus, thyroid problems, and several autoinmune or rheumatic diseases (I do not know exactly which ones). All blood tests were normal.

The neurologist ordered a brain and spinal MRI without contrast, which showed no alterations which could explain my symptoms. Then I underwent an EMG, which also was completely normal. I had another blood test done: Lyme disease was ruled out, I have no folic acid or B12 vitamin deficiencies and there are no antibodies against striated muscle. Levels of acetylcholine receptors were in the indetermined zone (0.25 nmol/l), but the neurologist said that was not relevant at all. So, having seen all these results, she told me any neurological or neuromuscular disorder was ruled out, and sent me to the rheumatologist.

I would like to know your opinion. Do you think any other tests could have been ordered for diagnosis, or was it enough?

Thank you very much. I look forward to your answers.