Body Tingling: Possible Causes and Recommendations - Neurology

Dr. Jiang Junyi reply Neurology

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Hello: Your symptoms appear at the extremities, which may suggest a deficiency in B vitamins or abnormal electrolyte levels causing peripheral neuropathy.
Clinically, many conditions can lead to hyperventilation, including sepsis, significant blood loss, hypoxia, and acute myocardial infarction, during which patients often exhibit rapid and deep breathing.
"Hyperventilation syndrome" generally refers to hyperventilation phenomena of unknown etiology; the aforementioned physiological conditions leading to hyperventilation do not typically fall under this syndrome.
Hyperventilation causes a decrease in carbon dioxide levels in the blood, resulting in an increased pH, medically termed "respiratory alkalosis," which can trigger systemic reactions and symptoms.
Common manifestations include vasoconstriction and decreased calcium levels in the blood.
Reduced blood flow to the brain due to vasoconstriction can lead to dizziness, numbness (especially around the lips and upper limbs), and weakness; in more severe cases, agitation, hallucinations, seizures, or fainting may occur.
Decreased blood calcium can cause muscle spasms and cramps in the hands and feet.
Low carbon dioxide levels often make patients feel short of breath, and excessive breathing can lead to chest pain, dry mouth from rapid breathing, and sometimes air entering the gastrointestinal tract, causing bloating and belching.
"Hyperventilation syndrome" can be classified into acute and chronic forms, with the exact etiology remaining unclear.
It is more common in younger individuals (ages 15-55), with a higher prevalence in females (7:1).
Acute episodes present with noticeable rapid and deep breathing, and other related symptoms are typically more pronounced, prompting patients to seek emergency care, making diagnosis easier.
Unfortunately, the majority of patients fall into the chronic category, making it difficult to notice the acceleration or deepening of breathing, often presenting with chest pain and shortness of breath in thoracic clinics, and they may endure painful examinations due to diagnostic challenges.
Patients are generally more anxious and have a lower capacity to cope with stress, with symptoms sometimes exacerbated by family or marital issues.
The diagnosis of "chronic hyperventilation syndrome" requires the exclusion of physiological diseases; therefore, basic examinations such as pulmonary function tests, electrocardiograms, chest X-rays, and blood tests are necessary to avoid delaying the identification of potential underlying conditions.
A definitive diagnosis can be made through arterial blood gas analysis, confirming the patient's low carbon dioxide levels.
Additional information: Symptoms are particularly severe when fatigued, and the patient often experiences fatigue and weakness.
There are gastrointestinal issues such as duodenal ulcers and gastric erosions with gastroesophageal reflux (currently not on medication), along with mild sleep disturbances (occasionally using sleep aids).
The patient works extensively on a computer, requiring prolonged sitting, often leading to poor blood circulation and cold extremities.
Tenderness may slightly alleviate with several days of continuous movement but quickly returns.
I would like to ask the doctor how such a condition could arise? Is it due to inflammation in some part of the body, or could there be other reasons? The discomfort is significantly affecting daily life, and I am currently unable to return to Taiwan for medical care and am unsure which specialty to consult.
I hope the physician can assist.

Hello: Your symptoms resemble neuropathic pain, which is typically caused by damage or disease affecting the somatosensory nervous system.
It particularly suggests peripheral nervous system involvement, commonly seen in postherpetic neuralgia, but pain from some central nervous system disorders (such as post-brain injury, spinal cord injury, multiple sclerosis, etc.) should also be considered.
Myofascial pain syndrome in the back is another possibility.
Current treatments for neuropathic pain primarily target the underlying causes.
It may be beneficial to supplement with B vitamins and remind yourself to stand up and stretch every half hour to avoid nerve compression and muscle tightness that could exacerbate symptoms.
I recommend consulting a neurologist for further evaluation and treatment.
Wishing you good health and peace.
Dr.
Jiang, Department of Neurology, Taoyuan Hospital, cares about you.

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Reply Date: 2018/08/29