Sudden onset tingling and pins and needles after drinking alcohol. liver and kidney labwork is normal. ncv and emg normal. brain mri norml. cause?

Alcohol: Alcohol alters nerve conduction by occupying the GABA receptor in the brain. Tingling can sometimes occur. If it is on both sides, that is the likely cause. If you want to avoid it in the future, avoid alcohol. If you develop weakness of arm or leg on one side, slurred speech, or other concerning symptoms, go to the ER. Hope this helps!

Pins &needles: This is difficult But if there has been a long history of alcohol use it could be a vitamin defficiency or an early alcohol induced neuropathy which does not show on testing yet.

Neuropathy: Your symptoms are suggestive of neuropathy. It cab be caused by variety of causes. It does needs additional w/u. The testings you had can be normal still can have neuropathy. Some all test could be negative with the symptoms you have. Consult a neurologist.