Nerve Compression: Symptoms of Tingling in Limbs and Face

Numbness in the hands and feet, and even the face is starting to feel numb?

Hello, Dr.
Jiang.
Last month, I suddenly woke up one morning with simultaneous numbness in my left arm and leg.
This sensation felt different from just an abnormal sleeping position.
Even during the day, I occasionally feel numbness in my left hand or foot.
For about a week, I experienced this numbness waking me up around 5 AM for three days.
Initially, I was very concerned it might be a precursor to a stroke, so I quickly registered with a nearby Chang Gung Hospital in Taoyuan.
After a simple examination, the doctor concluded it was likely not caused by a stroke (considering my youth, absence of hypertension, and that it was numbness rather than weakness, with no facial abnormalities).
They arranged for an electromyography (EMG) and nerve conduction study, but since the appointment is scheduled for about a month later, I haven't had it yet.

However, in the following weeks, the situation has changed slightly.
I no longer experience waking up numb in the morning; instead, I now have numbness in my right arm and leg as well.
Essentially, I feel numbness in all four limbs after work or during the day.
Sometimes it's in both feet, sometimes in my left upper arm accompanied by shoulder or back discomfort, and at times it could be in one or both forearms, or even in my palms and fingers.
Recently, I've also experienced occasional numbness in my face, particularly around my nose and mouth.

Could this be more indicative of cervical or thoracic spine nerve compression, or as some have suggested, could it simply be caused by excessive stress leading to autonomic nervous system dysregulation? Thank you.

Ayu, 30~39 year old female. Ask Date: 2017/07/13

Dr. Jiang Junyi reply Neurology

Hello, you mentioned that the issue of unilateral limb numbness is more indicative of cervical nerve root compression.
As for the tingling sensations around the mouth and in the limbs, it may be necessary to consider hyperventilation syndrome.
The typical symptoms include chest tightness, chest pain, palpitations, shortness of breath, numbness in the hands and feet, scalp numbness, and an inability to lie still in bed.
Physical examination may reveal tachycardia, but other findings are non-specific.
Laboratory tests may show a slight decrease in potassium levels, arterial blood gas analysis may indicate respiratory alkalosis, and oxygen saturation is normal; this is due to excessive carbon dioxide being expelled from the body, leading to an abnormal acid-base balance.
It is recommended that you consult a neurologist for further evaluation and treatment.
Wishing you good health and peace.
Dr.
Tao, Neurology, is concerned about you.

Reply Date: 2017/07/13

More Info

Hello! Thank you for sharing your concerns regarding the tingling sensations in your limbs and face. Based on your description, it seems you are experiencing a range of symptoms that could be attributed to several underlying causes, including nerve compression or autonomic nervous system dysregulation due to stress.

Tingling sensations, medically known as paresthesia, can arise from various conditions. Given that you initially experienced these sensations in your left side and now have them in both sides, it is essential to consider the possibility of nerve compression, particularly in the cervical or thoracic spine. Nerve compression can occur due to herniated discs, bone spurs, or other spinal issues that may impinge on the nerves exiting the spinal column. This can lead to symptoms such as tingling, numbness, and weakness in the affected areas.

The fact that you have undergone preliminary evaluations and that a stroke has been ruled out is reassuring. Stroke typically presents with sudden onset of weakness, numbness, or facial drooping, often accompanied by other neurological deficits. Since you mentioned that your symptoms have evolved to include both sides of your body and even your face, this could suggest a more systemic issue or a different type of nerve involvement.

Stress and anxiety can also play a significant role in the presentation of these symptoms. When under stress, the body can enter a heightened state of arousal, which may lead to hyperventilation or muscle tension. This can cause sensations of tingling or numbness, particularly in the extremities and face. The autonomic nervous system, which regulates involuntary bodily functions, can become dysregulated during periods of high stress, leading to symptoms that mimic those of nerve compression.

It is also worth noting that certain lifestyle factors, such as prolonged poor posture, repetitive movements, or even sleeping positions, can contribute to nerve compression and resultant symptoms. If you have a job that requires you to sit for long periods or perform repetitive tasks, this could exacerbate your symptoms.

Given your symptoms, it is advisable to continue with the planned nerve conduction studies and electromyography (EMG) to assess the function of your nerves and muscles. These tests can help determine if there is any underlying nerve damage or compression that needs to be addressed. In the meantime, consider implementing stress-reduction techniques such as mindfulness, yoga, or physical therapy to help alleviate some of the tension that may be contributing to your symptoms.

If your symptoms persist or worsen, or if you experience new symptoms such as weakness, loss of coordination, or changes in bowel or bladder function, it is crucial to seek immediate medical attention. These could be signs of a more serious condition that requires prompt evaluation.

In summary, while your symptoms could be related to nerve compression, they may also be influenced by stress and anxiety. A thorough evaluation by a neurologist, along with appropriate diagnostic tests, will provide clarity on the underlying cause of your symptoms and guide you toward the most effective treatment options. Take care, and I wish you the best in your journey toward recovery!

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