Brief Answer:
You are correct in wanting to take him for an examination

Detailed Answer:
Good evening. Thank you for asking your question on this network and hopefully the following ideas will give you some things to think about and ask questions of the doctor when you take your son. I'm a neurologist so that you are aware of my slant on this type of story.

There are several things that could cause a person to not feel a part of the body as well as before or as well as other parts. The important part of this problem is to get the proper information from your son as to exactly when this all started and especially zero in on times in the past when he may have had similar episodes happening over other parts of his body which he may not have even paid much attention to just because it wasn't as noticeable as what he experienced today or in the past few days. You also mention another clue that some episodes in the past didn't seem to last as long as the one that is going on now. This is also an important piece of information.

He may be suffering from deficits in nutritional elements such as B12, folate, or Vitamin D and these are easily corrected. By the same token he may also be suffering from problems with his thyroid and that should be checked. Most doctors may only order what is called a TSH to check the thyroid gland, however, if he were my patient and in this situation I would like choose to order not only a TSH but also a Total T4 (TT4) as well as a Free T4 (FT4). These are just 2 other tests that complement the TSH very well and can resolve any doubts in case the TSH is a bit equivocal.

One thing that will have to be looked at carefully though with these sorts of symptoms is a possible autoimmune type of problem known as demyelinating disease and for that the most sensitive test that can be done is an MRI of the brain and usually we do it with gadolinium contrast. We are looking for any evidence of neurons in the brain that may be under attack by the immune system resulting in a loss of their insulation or covering known as MYELIN hence the term, DEMYELINATION. A specific example of such a disease would be multiple sclerosis. Another example would be neurosarcoidosis.

It is not possible to say exactly what is going on though until he is examined and a good history is obtained so the best thing that you and he can do would be to see the doctor, perform the tests that are recommended, and then, see what comes about after that...I would not necessarily submit your son for a spinal tap since nowadays testing cerebrospinal fluid is considered unnecessary for the detection of demyelinating disease and so I would prefer to see him undergo other tests rather than that one if it were offered.

I also don't think that other neurological tests such as electrical needle or conduction studies also known as EMG or EEG tests are necessary in this case as he is not having any motor problems nor is he suffering from changes in mental status. I only mention these things because I've seen such patients be put through such paces unnecessarily.

Of course, if there is another legitimate reason to do any of these tests and that is discovered by way of more detailed history or by finding something on the neurological examination then, of course, they should be done....but typically not if the search is on for demyelinating disease such as MS or sarcoidosis.

Of course, there are other less common but still important causes for this type of picture which can be seen during infections such as with Lyme disease or other tick borne illnesses. Depending upon where you live and whether or not your son is an outdoors person, hunts deer, etc. he may be at some risk for this entity as well....bottom line....he needs that exam and in my opinion because of his symptoms I believe a neurologist would be a very appropriate type of specialist to call on consult.

I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. Feel free to upload more specific information regarding lab tests and diagnostic studies if done and I'll be happy to look at them when completed.

Otherwise, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback. In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my responses.

Write to me any time at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered.

This consult request has taken a total of 42 minutes of time to read, research, and respond.

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