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And the moment has finally come. This week's #NeuroWord (that is actually 2 words) is...
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NUMBNESS & TINGLING
(Thread)
#neuroscience #NeuroTwitter #Neurology
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NUMBNESS & TINGLING(Thread)
#neuroscience #NeuroTwitter #Neurology
I decided these ones because they are two very typical words in the #Neurology clinical cases articles and in the real clinical practice.
You can hace numbness and tingling in your face
, arm
, hand
, leg
, toe
and wherever you can imagine 
.
You can hace numbness and tingling in your face
, arm, hand, leg, toe and wherever you can imagine .
In fact, every human being might have had one of these two symptoms in his or her life.
It is so common that #neurologists must develop the ability to figure out when these symptoms ARE REALLY a true neurologic impairment.
It is so common that #neurologists must develop the ability to figure out when these symptoms ARE REALLY a true neurologic impairment.
The translation to Spanish:
- Numbness Adormecimiento 
, entumecimiento.
- Tingling Hormigueo 
, cosquilleo.
- Numbness
Adormecimiento , entumecimiento. - Tingling
Hormigueo , cosquilleo.
They are both sensory abnormalities, but they are strictly opposite:
Numbness is a NEGATIVE
symptom (lack of sensation).
Tingling is a POSITIVE
symptom (excessive or unusual sensation).
Numbness is a NEGATIVE symptom (lack of sensation). Tingling is a POSITIVE symptom (excessive or unusual sensation).
What can cause these
Mostly every part of the peripheral and nervous system can cause it
Probably the most common cause are impairments of the peripheral nerves and nerve roots
But also damage to cerebral cortex and deep tracts, and also spinal cord can produce them.
Mostly every part of the peripheral and nervous system can cause it
Probably the most common cause are impairments of the peripheral nerves and nerve roots
But also damage to cerebral cortex and deep tracts, and also spinal cord can produce them.
Maybe tingling is more likely to be produced by peripheral nervous system damage than numbness.
Numbness is found in a similar proportion of central and peripheral damage.
Numbness is found in a similar proportion of central and peripheral damage.
One easy way (or not that easy if you havent't donde enough neurologic examinations) to differentiate the central or peripheral etiology is to find central or periphetal extra signs RELATED to the symptoms.
i.e. numbness of left leg with dismetria and Babinski sign (CNS origin).
i.e. numbness of left leg with dismetria and Babinski sign (CNS origin).
Another way is trying to exhaustively localize (not always possible) the area of skin affected. For instance:
HEMIcorporalUsually CNS.
WHOLE limbPlexus or CNS.
SOME part of limbPeripheral nerve.
DERMATOMENerve root.
Feets & handsPolineuropathy.
HEMIcorporalUsually CNS.WHOLE limbPlexus or CNS.SOME part of limbPeripheral nerve.DERMATOMENerve root.Feets & handsPolineuropathy.
It is also important to ask the patient what is numbness or tingling for them
Sometimes they refer to WEAKNESS as numbness, or they say tingling but is a more difficult-to-explain sensation like HYPERALGESIA and ALLODYNIA or even myokimia or myotonia
Sometimes they refer to WEAKNESS as numbness, or they say tingling but is a more difficult-to-explain sensation like HYPERALGESIA and ALLODYNIA or even myokimia or myotonia
Nonetheless, it's frequent to find that some people think it is not an important symptom and they avoid to consult to their doctor.
But it is always recommended to consult when it's and unexplained and unusual symtom
.
.But it is always recommended to consult when it's and unexplained and unusual symtom
.
Yesterday I was on-call and saw 1 patient with numbness and tingling of both feet which progressed to the legs in 7 days with an ataxic gait and urinary incontinence.
Also another patient with a TIA who referred to a transitory weakness of the arm as "numbness".
#Neurology
Also another patient with a TIA who referred to a transitory weakness of the arm as "numbness".
#Neurology
You will see this symptoms as a doctor every day, it doesn't matter if you are a Neurologist or not, so be prepared for when it comes to you.
#NeuroWord #Neurology #TheEnd
#NeuroWord #Neurology #TheEnd
