Left-Sided Numbness and Weakness: Possible Causes and Next Steps

Numbness and weakness in the left hand and foot?

Hello Doctor: For the past two weeks, I have been experiencing numbness in my left hand and foot, particularly in my fingers.
Additionally, my left hand has been shaking uncontrollably.
The numbness is persistent and spreads quickly when I raise my hand or cross my legs.
While playing basketball, I feel a lack of coordination on my left side and have difficulty exerting force, especially during jumping movements, such as when attempting a layup.
I also experience stiffness in my shoulders and neck, and my left side is difficult to move.
When I tilt my head back, my vision occasionally goes black, and sometimes my left eye feels swollen.
This eye swelling symptom has been present for over six months.
Recently, when I feel the swelling, I check my blood pressure, which tends to be on the higher side (around 135/90), and my heart rate remains above 90.
I am on the thinner side (174 cm/57 kg).
Before the numbness in my left hand and foot started, I often felt stiffness in my right upper neck, along with a sensation of fullness in my right ear.
I have seen specialists in "Otolaryngology" and "Rehabilitation Medicine," and I was prescribed "Mikobol" and "Becofin" for a period.
Could these medications be causing the numbness and weakness in my limbs? I also frequently massage my upper neck; could this have caused neck injury? This week, I visited a doctor who performed a "cervical X-ray," "electromyography," and blood tests related to my thyroid.
However, during my follow-up appointment, the doctor said all the reports were normal.
What other potential causes could explain these symptoms? What additional tests would you recommend?

Xiao Hao, 20~29 year old female. Ask Date: 2018/07/24

Dr. Jiang Junyi reply Neurology

Hello, based on your description, the medication Micobalamin is Vitamin B12, while Baclofen is a muscle relaxant that may cause muscle weakness.
A common cause of neck pain is cervical myofascial pain: prolonged periods of looking down can lead to overuse of the trapezius muscle in the back of the neck, resulting in neck and shoulder discomfort.
Initially, resting may alleviate the pain, but it can progressively worsen and affect daily activities.
Some patients experience severe neck pain upon waking, characterized by stiffness, tightness, and intolerable pain levels.

It is recommended to:
1.
Change positions: Alter your posture every 15 minutes to allow the neck tissues to rest.
Maintaining any posture (including a normal one) for an extended period can lead to tissue fatigue and inflammation, so moving frequently can reduce the risk of muscle inflammation.

2.
Rest: Resting allows the muscles to utilize their self-repair capabilities; vigorous exercise should be avoided during this time.

3.
Apply heat to the neck: Use a heating pad for 15 to 20 minutes, ensuring the temperature is safe to avoid burns.

4.
Non-steroidal anti-inflammatory drugs (NSAIDs): For individuals without a history of gastric ulcers, allergies to NSAIDs, or normal kidney function, consider using NSAIDs to reduce inflammation and alleviate pain if necessary.

5.
Neck muscle stretching exercises: After the acute pain phase, it is advisable to develop a routine of slow, gentle neck stretches every 15 to 20 minutes, avoiding positions that cause discomfort.

Electromyography (EMG) is primarily used to check for nerve damage or muscle pathology.
It is recommended that you consult with a neurologist or a rehabilitation physician to discuss examination and treatment options.
Wishing you good health.
Dr.
Jiang from Taoyuan Hospital cares about you.

Reply Date: 2018/07/24

More Info

Based on the symptoms you've described, it seems you are experiencing a combination of left-sided numbness, weakness, and coordination issues, particularly affecting your left hand and foot. These symptoms can be concerning and may stem from various underlying causes. Let's break down the possible reasons for your symptoms and the next steps you should consider.

Possible Causes
1. Nerve Compression or Injury: Given your symptoms of numbness and weakness, one potential cause could be nerve compression, possibly from a herniated disc in the cervical spine or thoracic outlet syndrome. These conditions can lead to symptoms in the arms and legs due to pressure on the nerves.

2. Cervical Radiculopathy: The stiffness and discomfort in your neck, along with the numbness and weakness in your left arm and leg, may suggest cervical radiculopathy. This occurs when a nerve in the neck is compressed or irritated, leading to pain, weakness, or numbness that radiates down the arm.

3. Circulatory Issues: High blood pressure and elevated heart rate, as you've mentioned, could indicate circulatory problems. If blood flow to certain areas is compromised, it can lead to numbness and weakness.

4. Neurological Conditions: While less likely given your age and the normal results from your tests, conditions such as multiple sclerosis or other neurological disorders can sometimes present with similar symptoms. However, these typically would show abnormalities on imaging or nerve conduction studies.

5. Medication Side Effects: You mentioned taking medications like "Mikobor" and "Beckofen." While these medications are generally used for muscle relaxation and pain relief, they can sometimes cause side effects, including dizziness or numbness. However, it’s essential to consult your doctor about any potential side effects related to your specific medications.

6. Muscle Strain or Injury: The stiffness in your neck and the self-massage you’ve been doing could potentially lead to muscle strain, which might contribute to your symptoms. Chronic muscle tension can lead to referred pain and discomfort in other areas.

Recommended Next Steps
1. Follow-Up with a Neurologist: Since your initial tests have returned normal, it may be beneficial to consult a neurologist for a more in-depth evaluation. They may recommend additional tests, such as an MRI of the cervical spine, to rule out any structural issues that could be affecting the nerves.

2. Physical Therapy: Engaging in physical therapy can help strengthen the muscles around your neck and improve your posture, which may alleviate some of the pressure on your nerves. A physical therapist can also provide exercises tailored to your specific symptoms.

3. Further Blood Tests: If thyroid issues or other metabolic conditions are suspected, further blood tests may be warranted. It’s essential to ensure that your thyroid function is normal, as thyroid disorders can sometimes lead to neurological symptoms.

4. Lifestyle Modifications: Managing your blood pressure through diet, exercise, and stress reduction techniques can be beneficial. Regular cardiovascular exercise can improve circulation and overall health.

5. Monitor Symptoms: Keep a detailed log of your symptoms, noting when they occur, their intensity, and any potential triggers. This information can be invaluable for your healthcare provider in diagnosing the issue.

6. Consider a Second Opinion: If you continue to experience symptoms without a clear diagnosis, seeking a second opinion from another healthcare provider may provide new insights or alternative treatment options.

Conclusion
Your symptoms of left-sided numbness, weakness, and coordination issues warrant careful evaluation. While your initial tests have returned normal, it’s crucial to continue investigating the underlying causes. A multidisciplinary approach involving neurology, physical therapy, and lifestyle modifications may yield the best outcomes. Always consult your healthcare provider before making any changes to your treatment plan or medications.

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