And the moment has finally come. This week& #39;s #NeuroWord (that is actually 2 words) is...
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https://abs.twimg.com/emoji/v2/... draggable="false" alt="➡️" title="Pfeil nach rechts" aria-label="Emoji: Pfeil nach rechts"> 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 facehttps://abs.twimg.com/emoji/v2/... draggable="false" alt="👩‍🦰" title="Woman, red haired" aria-label="Emoji: Woman, red haired">, armhttps://abs.twimg.com/emoji/v2/... draggable="false" alt="💪" title="Angespannter Bizeps" aria-label="Emoji: Angespannter Bizeps">, handhttps://abs.twimg.com/emoji/v2/... draggable="false" alt="🤚" title="Erhobener Handrücken" aria-label="Emoji: Erhobener Handrücken">, leghttps://abs.twimg.com/emoji/v2/... draggable="false" alt="🦵" title="Leg" aria-label="Emoji: Leg">, toehttps://abs.twimg.com/emoji/v2/... draggable="false" alt="🦶" title="Foot" aria-label="Emoji: Foot"> and wherever you can imagine https://abs.twimg.com/emoji/v2/... draggable="false" alt="👂" title="Ohr" aria-label="Emoji: Ohr">https://abs.twimg.com/emoji/v2/... draggable="false" alt="👃" title="Nase" aria-label="Emoji: Nase">https://abs.twimg.com/emoji/v2/... draggable="false" alt="👅" title="Zunge" aria-label="Emoji: Zunge">https://abs.twimg.com/emoji/v2/... draggable="false" alt="👄" title="Mund" aria-label="Emoji: Mund">https://abs.twimg.com/emoji/v2/... draggable="false" alt="🍆" title="Aubergine" aria-label="Emoji: Aubergine">https://abs.twimg.com/emoji/v2/... draggable="false" alt="👍" title="Thumbs up" aria-label="Emoji: Thumbs up">.

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.

The translation to Spanish:
https://abs.twimg.com/emoji/v2/... draggable="false" alt="👇" title="Rückhand Zeigefinger nach unten" aria-label="Emoji: Rückhand Zeigefinger nach unten">
- Numbness https://abs.twimg.com/emoji/v2/... draggable="false" alt="➡️" title="Pfeil nach rechts" aria-label="Emoji: Pfeil nach rechts"> Adormecimiento https://abs.twimg.com/emoji/v2/... draggable="false" alt="😴" title="Schlafendes Gesicht" aria-label="Emoji: Schlafendes Gesicht">, entumecimiento.

- Tingling https://abs.twimg.com/emoji/v2/... draggable="false" alt="➡️" title="Pfeil nach rechts" aria-label="Emoji: Pfeil nach rechts"> Hormigueo https://abs.twimg.com/emoji/v2/... draggable="false" alt="🐜" title="Ameise" aria-label="Emoji: Ameise">, cosquilleo.

They are both sensory abnormalities, but they are strictly opposite:

https://abs.twimg.com/emoji/v2/... draggable="false" alt="➡️" title="Pfeil nach rechts" aria-label="Emoji: Pfeil nach rechts"> Numbness is a NEGATIVEhttps://abs.twimg.com/emoji/v2/... draggable="false" alt="❌" title="Kreuzzeichen" aria-label="Emoji: Kreuzzeichen"> symptom (lack of sensation).

https://abs.twimg.com/emoji/v2/... draggable="false" alt="➡️" title="Pfeil nach rechts" aria-label="Emoji: Pfeil nach rechts"> Tingling is a POSITIVEhttps://abs.twimg.com/emoji/v2/... draggable="false" alt="✅" title="Fettes weißes Häkchen" aria-label="Emoji: Fettes weißes Häkchen"> symptom (excessive or unusual sensation).

What can cause thesehttps://abs.twimg.com/emoji/v2/... draggable="false" alt="❓" title="Rotes Fragezeichen-Symbol" aria-label="Emoji: Rotes Fragezeichen-Symbol">

Mostly every part of the peripheral and nervous system can cause ithttps://abs.twimg.com/emoji/v2/... draggable="false" alt="🆘" title="Quadratisches SOS" aria-label="Emoji: Quadratisches SOS">

Probably the most common cause are impairments of the peripheral nerves and nerve rootshttps://abs.twimg.com/emoji/v2/... draggable="false" alt="❕" title="Weißes Ausrufezeichen Symbol" aria-label="Emoji: Weißes Ausrufezeichen Symbol">

But also damage to cerebral cortex and deep tracts, and also spinal cord can produce them.https://abs.twimg.com/emoji/v2/... draggable="false" alt="👁" title="Auge" aria-label="Emoji: Auge">

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.

One easy way (or not that easy if you havent& #39;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).

Another way is trying to exhaustively localize (not always possible) the area of skin affected. For instance:
https://abs.twimg.com/emoji/v2/... draggable="false" alt="👉" title="Rückhand Zeigefinger nach rechts" aria-label="Emoji: Rückhand Zeigefinger nach rechts">HEMIcorporalhttps://abs.twimg.com/emoji/v2/... draggable="false" alt="➡️" title="Pfeil nach rechts" aria-label="Emoji: Pfeil nach rechts">Usually CNS.
https://abs.twimg.com/emoji/v2/... draggable="false" alt="👉" title="Rückhand Zeigefinger nach rechts" aria-label="Emoji: Rückhand Zeigefinger nach rechts">WHOLE limbhttps://abs.twimg.com/emoji/v2/... draggable="false" alt="➡️" title="Pfeil nach rechts" aria-label="Emoji: Pfeil nach rechts">Plexus or CNS.
https://abs.twimg.com/emoji/v2/... draggable="false" alt="👉" title="Rückhand Zeigefinger nach rechts" aria-label="Emoji: Rückhand Zeigefinger nach rechts">SOME part of limbhttps://abs.twimg.com/emoji/v2/... draggable="false" alt="➡️" title="Pfeil nach rechts" aria-label="Emoji: Pfeil nach rechts">Peripheral nerve.
https://abs.twimg.com/emoji/v2/... draggable="false" alt="👉" title="Rückhand Zeigefinger nach rechts" aria-label="Emoji: Rückhand Zeigefinger nach rechts">DERMATOMEhttps://abs.twimg.com/emoji/v2/... draggable="false" alt="➡️" title="Pfeil nach rechts" aria-label="Emoji: Pfeil nach rechts">Nerve root.
https://abs.twimg.com/emoji/v2/... draggable="false" alt="👉" title="Rückhand Zeigefinger nach rechts" aria-label="Emoji: Rückhand Zeigefinger nach rechts">Feets & handshttps://abs.twimg.com/emoji/v2/... draggable="false" alt="➡️" title="Pfeil nach rechts" aria-label="Emoji: Pfeil nach rechts">Polineuropathy.

It is also important to ask the patient what is numbness or tingling for themhttps://abs.twimg.com/emoji/v2/... draggable="false" alt="✅" title="Fettes weißes Häkchen" aria-label="Emoji: Fettes weißes Häkchen">

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 myotoniahttps://abs.twimg.com/emoji/v2/... draggable="false" alt="‼️" title="Doppeltes Ausrufezeichen" aria-label="Emoji: Doppeltes Ausrufezeichen">

Nonetheless, it& #39;s frequent to find that some people think it is not an important symptom and they avoid to consult to their doctorhttps://abs.twimg.com/emoji/v2/... draggable="false" alt="❌" title="Kreuzzeichen" aria-label="Emoji: Kreuzzeichen">.

But it is always recommended to consult when it& #39;s and unexplained and unusual symtomhttps://abs.twimg.com/emoji/v2/... draggable="false" alt="👨‍⚕️" title="Man health worker" aria-label="Emoji: Man health worker">https://abs.twimg.com/emoji/v2/... draggable="false" alt="👩‍⚕️" title="Woman health worker" aria-label="Emoji: Woman health worker">.

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

You will see this symptoms as a doctor every day, it doesn& #39;t matter if you are a Neurologist or not, so be prepared for when it comes to you.
#NeuroWord #Neurology #TheEnd