Persistent Foot Numbness: Is It Related to Autonomic Dysfunction?

Numbness in the soles of the feet?

Hello, doctor.
Three years ago, I was diagnosed with autonomic nervous system dysfunction due to dizziness.
After taking medication, my condition improved significantly, and I stopped taking the medication.
However, I have experienced intermittent dizziness since then, which usually resolves quickly.
Recently, I have been experiencing dizziness again, sometimes feeling dizzy with just a slight movement.
Additionally, I have developed a persistent tingling sensation in the soles of my feet throughout the day.
It's not the intense numbness we feel after sitting too long; rather, it's a continuous tingling sensation, and my feet feel cold.
It gets a bit better after I wake up but returns after a while.
I would like to know if this is related to the autonomic nervous system.
Thank you.

Hsuan, 30~39 year old female. Ask Date: 2023/02/01

Dr. Jiang Junyi reply Neurology

Dear Ms.
Hsuan,
You mentioned experiencing dizziness that sometimes occurs with movement.
Benign Paroxysmal Positional Vertigo (BPPV) should be considered first.
The characteristic symptoms include brief episodes of vertigo related to changes in head position, such as bending over, looking up, lying down, getting up, rolling over, or suddenly turning the head.
These episodes may be accompanied by symptoms such as nausea, vomiting, palpitations, cold sweats, and feelings of weakness.
Regarding your description of a persistent numbness and cold sensation in your legs, peripheral nerve issues should be considered first.
The symptoms are often symmetrical, with both sides of the body experiencing numbness or insensitivity.
Testing one side is usually sufficient; however, if the nerve damage is due to a stroke or trauma, it would typically affect only one side, necessitating a comparison of results from both sides.
Peripheral nerve examinations are divided into two types: "nerve conduction studies," which are traditional tests primarily assessing large fiber nerves.
If the numbness extends rapidly upwards, acute demyelinating polyneuropathy should be considered, which is a neurological emergency that requires immediate medical attention.
Thank you for your inquiry.
I encourage you to discuss further with a neurologist regarding examination and treatment options.
Wishing you good health and peace.
Sincerely,
Dr.
Jiang Junyi
Department of Neurology, Taoyuan Hospital

Reply Date: 2023/02/01

More Info

Persistent foot numbness, particularly when accompanied by sensations of coldness and dizziness, can indeed be related to autonomic dysfunction, especially given your history of diagnosed autonomic dysregulation. The autonomic nervous system (ANS) controls involuntary bodily functions, including heart rate, blood pressure, digestion, and the regulation of body temperature. When this system is not functioning optimally, it can lead to a variety of symptoms, including those affecting the extremities.

In your case, the persistent numbness and cold sensation in your feet could be indicative of several underlying issues. One possibility is that autonomic dysfunction is affecting blood flow to your extremities, leading to the cold and numb sensations. The ANS plays a crucial role in regulating vascular tone and blood flow; when it is dysregulated, it can result in inadequate blood supply to the feet, causing them to feel cold and numb.

Additionally, the sensation of persistent numbness in the feet could also be a sign of peripheral neuropathy, which can occur due to various factors, including diabetes, vitamin deficiencies (such as B12), or even as a side effect of certain medications. Given your history of dizziness and autonomic issues, it is also important to consider that these symptoms could be interrelated. For instance, if your blood pressure drops upon standing (orthostatic hypotension), it could lead to dizziness and potentially contribute to sensations in your feet.

Another aspect to consider is the possibility of a condition known as small fiber neuropathy, which affects the small nerve fibers responsible for transmitting pain and temperature sensations. This condition can be associated with autonomic dysfunction and may lead to symptoms such as numbness, tingling, and a feeling of coldness in the feet.

It is also worth noting that stress and anxiety can exacerbate autonomic dysfunction, leading to increased symptoms. If you are experiencing heightened levels of stress or anxiety, this could contribute to the sensations you are feeling in your feet and the recurrence of dizziness.

To address your concerns, it is advisable to consult with a healthcare professional who specializes in neurology or autonomic disorders. They may recommend a thorough evaluation, including blood tests to check for vitamin deficiencies, glucose levels, and other potential causes of neuropathy. Additionally, they might suggest autonomic function tests to assess how well your autonomic nervous system is working.

In the meantime, maintaining a healthy lifestyle, including regular exercise, a balanced diet rich in vitamins, and stress management techniques, can be beneficial. Staying hydrated and avoiding prolonged periods of sitting or standing can also help improve circulation and potentially alleviate some of your symptoms.

In conclusion, while your persistent foot numbness and cold sensations could be related to autonomic dysfunction, it is essential to undergo a comprehensive evaluation to determine the exact cause and appropriate treatment. Your symptoms warrant further investigation to ensure that any underlying conditions are addressed effectively.

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