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Is this peripheral neuropathy?
Jan 19, 2006

Firstly, let me thank you, Drs Conway and Henry, so sincerely for the work you and your colleagues do on this site. It really is a huge help and wonderful resources to HIV sufferers across the world.

I am 22 year-old white male, positive for 18 months, VL 8,600, CD 300 (as at November 2005). I am completely asymptomatic apart from slightly enlarged lymph glands. I feel really healthy, on the whole, although I've been a little stressed since my diagnosis last October.

My question is: for the past 24 hours I've been experiencing a strange, tingling sensation at the tip of my right big toe. It first woke me up with a burning pain at 4am, and then continued with just mild numbness all day.

I understand that in HIV infection, peripheral neuropathy is generally symmetrical. My left side, so far, feels completely normal, and the tingling-numbness-weirdness doens't seem to have progressed to the rest of my toes on the right foot.

Does this sound like peripheral neuropathy to you? I should probably mention that I'm not on any treatment (and never have been), that my toe from the outside looks completely normal, that I'd spent the previous two days hiking in mountains, and that I can't certainly rule out the possibility that I might have knocked my foot against something. But I have been drinking quite a lot recently, and feeling pretty thirsty a lot of the time.

I'd really appreciate your comments, doctor. Thank you so much. Ben.

Response from Dr. Henry

Your description makes HIV-related peripheral neuropathy seem unlikely. Some sort of local compression neuropathy (as you mention related to your recent hiking) is certainly possible. KH



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