Nerve Issues: Why Are My Limbs Numb and Twitching?

Multiple areas of numbness throughout the body - Poor blood circulation?

Hello, Doctor.
Recently, I've noticed that when I sleep with my arms bent over my chest, my hands become numb.
In the past, certain positions didn't cause this numbness, but it has changed in the last two months.
Additionally, I've been experiencing muscle twitching in various parts of my body that can be seen with the naked eye.
My fingers often feel numb, and all five fingers have experienced this sensation.
A while ago, I also felt tightness and cramping in my left cheek, accompanied by pain, but it resolved after some time.
Occasionally, my upper lip and eyelids twitch, and I sometimes feel sudden numbness in my toes, calves, buttocks, neck, and scalp.
Could this situation be related to nerve damage or compression? I was previously diagnosed with autonomic nervous system dysfunction due to other symptoms, but now it seems to have shifted to a problem solely involving my nerves.
Additionally, blood tests revealed that my vitamin B12 level is only 298, but I received an injection last week to supplement it.
I'm unsure if these issues are due to vitamin deficiency or compression.
I hope you can help me analyze this situation.
I've seen many doctors in the past six months, but no one has been able to identify the problem.
Thank you!

ANAN, 20~29 year old female. Ask Date: 2017/05/13

Dr. Jiang Junyi reply Neurology

Hello, your symptoms may be related to hyperventilation syndrome.
Rapid or deep breathing can lead to excessive carbon dioxide elimination from the body, resulting in respiratory alkalosis, which is characterized by an elevated blood pH.
This condition can disrupt the normal electrophysiological processes of the nervous system.
Some patients may experience numbness or tingling sensations in the hands, feet, and lips, as well as slurred speech, dizziness, chest pain, palpitations, cold extremities, and nervous laughter.
The more anxious the patient becomes, the faster their breathing, creating a vicious cycle of symptoms, and in severe cases, it can lead to fainting.
It is advisable to consult a neurologist for evaluation and treatment.
Wishing you good health and peace.

Reply Date: 2017/05/13

More Info

It sounds like you are experiencing a complex array of symptoms that could be related to nerve issues, and it's understandable that you're seeking clarity on what might be happening. Based on your description, several factors could be contributing to your symptoms, including nerve compression, vitamin deficiencies, and possibly other underlying conditions.

Firstly, the numbness and twitching you are experiencing in your limbs, particularly when your arms are in certain positions, could indicate nerve compression. This often occurs when a nerve is pinched or irritated, which can happen due to poor posture, repetitive movements, or even sleeping in an awkward position. For example, if you sleep with your arms bent and resting on your chest, it can compress the nerves in your arms, leading to temporary numbness or tingling. This is often referred to as "paresthesia."
The twitching of your muscles, known as fasciculations, can also be associated with nerve irritation or damage. This can occur in various conditions, including benign fasciculation syndrome, which is generally harmless but can be distressing. However, if the twitching is widespread and accompanied by other neurological symptoms, it may warrant further investigation.

Your mention of experiencing numbness in your fingers, face, and other areas could suggest a more systemic issue. The fact that you have been diagnosed with autonomic nervous system dysregulation might indicate that your body is having difficulty managing its involuntary functions, which can sometimes lead to symptoms like those you are describing.
Vitamin B12 deficiency is another important factor to consider. Vitamin B12 is crucial for nerve health, and low levels can lead to neurological symptoms, including numbness, tingling, and weakness. Your reported level of 298 pg/mL is on the lower end of the normal range, and since you have received a B12 injection, it may take some time for your symptoms to improve as your body replenishes its stores.
It’s also worth noting that other vitamin deficiencies, such as vitamin D or magnesium, can contribute to muscle twitching and nerve issues. A comprehensive evaluation of your nutritional status could be beneficial.

Given the complexity of your symptoms and the fact that you've seen multiple doctors without a clear diagnosis, it may be worthwhile to consult with a neurologist who specializes in nerve disorders. They might recommend further testing, such as nerve conduction studies or electromyography (EMG), to assess the function of your nerves and muscles more thoroughly. Additionally, imaging studies like an MRI could help identify any structural issues that might be contributing to nerve compression.

In summary, your symptoms could be due to a combination of factors, including nerve compression, vitamin deficiencies, and possibly other neurological conditions. It’s essential to continue seeking medical advice and to advocate for comprehensive testing to get to the root of your issues. Keeping a detailed log of your symptoms, including when they occur and any potential triggers, can also be helpful for your healthcare providers in diagnosing your condition.

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