Loss of feeling in both feet

[jordanloughlin]

Did you palpate the posterior tibial pulse? Or better still if you have access to doppler, use that. Are symptoms variable? mechanical in nature, get worse with certain activities etc?

Jordan

[Kubrick123]

@gcoe - but it would be strange to have such symptoms without any ailments even in the thoracic area, right?
As for the neuroanatomy, the symptoms go along the line of medial dorsal cutaneous nerve but strangely in both feet..
@jordanloughlin - pulse is palpable without any disturbances. Symptoms are constant, without any change during activities.

[gcoe]

@gcoe - but it would be strange to have such symptoms without any ailments even in the thoracic area, right?

Not quite get your point here. Do yu mean it would be strange not to have any other symptoms? yes probably. The nervous system is so well protected by pain sensitive tissue it is hard to get damage without pain. One exception is a a tumour or other pathology that originates within the nervous system tissue itself - in this case there can be a lot of nervous system destruction before pain is experienced due to the anaesthetic nature of the the CNS.

As for the neuroanatomy, the symptoms go along the line of medial dorsal cutaneous nerve but strangely in both feet..

...yes maybe - but not sure from what you described it matches up that way. Wouldn't the area possibly also include the saphenous nerve, and medial platar nerve? Of course there can be a lot of anatomical variation in superficial nerves. I f you can do put up a diagram. If it is the medial plantar nerve then tarsal tunnel syndrome is the most common neuropathy but usually this is also very painful - usually you get burning pain and as you say that doesn't explain the bilateral nature of the symptoms. But a superficial nerve could possibly explain the difference in sensory modalities

Another stab in the darK - has she changed shoes recently? A superficial neuropathy caused by tight fitting shoes can happen but again usually very painful and P&Ns to start off with. But this could explain the bilateral nature. Haven't heard of a nerve entrapment caused by shoes in that area.

another stab in the dark - aren't swimmers more prone to spondylolisthesis? (not a sports physio here so may be out of line here) A significant slip could possibly cause such symptoms but again probably be accompanied by pain. Is there any history of back pan

All guess work at this stage.

[Dr Damien]

is this patient an unknown diabetic? If we have discussed a neurological explanations perhaps vascular possibilities should be considered...I agree with gcoe the age of this client makes this situation a little concerning, and a space occupying lesion at the dorsal column could be responsible...either way an MRI is good idea...

I would consider ruling out diabetes also...this is another condition wherein all central neuro tests will be ok when tested...

She needs to be fully examined, blood work and all...to be honest