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| Paresthesia Classification and external resources |
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| ICD-10 | R20.2 |
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| ICD-9 | 782.0, 355.1 |
Paresthesia (pron. /ˌpɛɹɪsˈθiʒə/; paraesthesia in British English, pron. /ˌpæɹɪsˈθiʒə/) is a sensation of tingling, pricking, or numbness of a person's skin with no apparent long-term physical effect. It is more generally known as the feeling of "pins and needles" or of a limb being "asleep" (although this is not directly related to the phenomenon of sleep). The manifestation of parasthesia may be transient or chronic.
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Transient
Paresthesia of the mouth, hands, and feet are common, transient symptoms of the related conditions of hyperventilation syndrome and panic attacks. It may also occur when pressure is put on a nerve. In the case of the latter, removing the pressure will gradually relieve the "pins and needles" feeling. Pressure placed on a limb can also squeeze arteries, preventing them from carrying nutrients.[1]
Chronic
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. Paresthesia can also be caused simply by blocking of the blood stream to a limb by applying weight [or pressure] on to the limb for extended periods of time. Another cause of paresthesia, however, may be direct damage to the nerves themselves, i.e. neuropathy, which itself 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, 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.
Other known causes
- Alcoholism
- Anticonvulsant drugs such as topiramate, sulthiame, and acetazolamide
- Anxiety and/or Panic Disorder
- Dehydration
- Fabry disease
- Fibromyalgia
- Guillain-Barre Syndrome (GBS)
- Heavy metals
- Hyperventilation
- Immune deficiency, such as Chronic inflammatory demyelinating polyneuropathy (CIDP)
- Ingestion of Beta-alanine
- Lidocaine poisoning
- Lomotil
- Low blood-sugar (Hypoglycaemia)
- Menopause
- Migraines
- Multiple sclerosis
- Nitrous Oxide, long term exposure [2]
- Obdormition
- Radiation poisoning
- Vitamin B5 deficiency
- Vitamin B12 deficiency
- Withdrawal from certain SSRIs, such as paroxetine
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, according to the underlying cause.
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
External links
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Wikipedia content modification information:
- This page was last modified on 18 August 2008, at 00:01.
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