Paresthesia

Paresthesia or paraesthesia (in British English) is a sensation of tingling, pricking, or numbness of a person's skin with no apparent long-term physical effect, more generally known as the feeling of pins and needles or of a limb being "asleep" (but not directly related to the phenomenon of sleep). Its manifestation may be transient or chronic.

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Chronic condition

Chronic paresthesia indicates a problem with the functioning of neurons.

In older individuals paresthesia is often the result of poor circulation in the limbs (such as in peripheral vascular disease), which may be caused by atherosclerosis — the build up of plaque on artery walls. Without a proper supply of blood and nutrients, nerve cells can no longer adequately send signals to the brain. Because of this, paresthesia can also be a symptom of vitamin deficiency and malnutrition, as well as metabolic disorders like diabetes, hypothyroidism, and hypoparathyroidism.

Irritation to the nerve can also come from inflammation to the surrounding tissue. Joint conditions such as rheumatoid arthritis and carpal tunnel syndrome are common sources of paresthesia. Nerves below the head may be compressed where chronic neck and spine problems exist and can be caused by, amongst other things, muscle cramps which may be a result of clinical anxiety or excessive mental stress, bone disease, bad posture, unsafe heavy lifting practices or physical trauma such as whiplash.

Another cause of paresthesia, however, may be direct damage to the nerves themselves, or neuropathy, which can stem from injury or infection such as Lyme disease, or which may be indicative of a current neurological disorder. Chronic paresthesia can sometimes be symptomatic of serious conditions, such as a transient ischemic attack, a brain tumor, motor neurone disease, or autoimmune disorders like multiple sclerosis or lupus erythematosus. The herpes zoster virus can attack nerves causing numbness instead of pain commonly associated with shingles. A diagnostic evaluation by a doctor is necessary to rule these out.

Paresthesiae of the mouth, hands, and feet are common, transient symptoms of the related conditions of hyperventilation syndrome and panic attacks.

Other known causes of paresthesia:

• Alcoholism
• Anticonvulsant drugs such as topiramate, sulthiame, and acetazolamide
• Dehydration
• Low blood-sugar (Hypoglycaemia)
• Fabry disease
• Fibromyalgia
• Heavy metals
• Hyperventilation
• Ingestion of Beta-alanine
• Lidocaine poisoning
• Migraines
• Multiple sclerosis
• Radiation poisoning
• Withdrawal from certain SSRIs, such as Paroxetine
• Vitamin B12 deficiency
• Immune deficiency, such as Chronic inflammatory demyelinating polyneuropathy (CIDP)
• Guillain-Barre Syndrome (GBS)
• Obdormition
• Lomotil

Treatment

Treatment should be decided by a neurologist. A CT scan is often used as a diagnostic tool.

Medications offered can include the immunosuppressant prednisone, intravenous gamma globulin (IVIG), anticonvulsants such as gabapentin or gabitril and antiviral medication, amongst others.

In some cases, rocking the head from side to side will painlessly remove the "pins and needles" sensation in less than a minute. A tingly hand or arm is often the result of compression in the bundle of nerves in the neck. Loosening the neck muscles releases the pressure. Compressed nerves lower in the body govern the feet, and standing up and walking around will typically relieve the sensation. An arm that has "fallen asleep" may also be "awoken" more quickly by clenching and unclenching the fist several times; the muscle movement increases blood flow and helps the limb return to normal.

Manipulation of the neck won't apply to facial paresthesia, such as early stages of Bell's palsy, as nerves of the face and scalp don't pass through the neck.

Paresthesia caused by shingles is treated with appropriate antiviral medication.

References

See also

• Neuropathy