Numbness and Tingling: Causes and When to Seek Help

Q: Numbness and Tingling: Causes and When to Seek Help

Hello： Your symptoms may suggest hyperventilation syndrome. <br>Hyperventilation leads to a decrease in carbon dioxide levels in the blood, resulting in an increased pH, a condition known medically as "respiratory alkalosis." This can cause systemic reactions and symptoms, with c

Numbness in the head and face?

Hello, doctor! Recently, I have been experiencing a sensation of vibration near my chest.
I'm not sure how to describe it; it feels very chaotic and uncomfortable, like a buzzing or tingling sensation.
Upon closer examination, I notice that this feeling also extends to my head and entire body, and I often feel dizzy.
When I experience this sensation, I frequently have the following symptoms: 1.
Tingling in my scalp, which sometimes feels cold and at other times feels warm, as if something is pressing inside my head.
2.
Tingling in my tongue and lips.
3.
A cold, tingling sensation in my face.
4.
My hands and feet also feel cold and tingly, accompanied by a slight feeling of weakness, with these sensations often occurring on the left side.
5.
Recently, I have also felt discomfort and pain near my heart.
I experienced similar symptoms six months ago and went to the emergency room, where I consulted with family medicine, cardiology, and neurology.
I underwent a cardiac ultrasound and a 24-hour Holter monitor, and the doctors said I have mild mitral valve prolapse and prescribed Entresto, advising that I could take it when I feel uncomfortable.
The neurologist conducted an EEG, carotid ultrasound, and nerve conduction studies, all of which showed no issues.
Could you please help me understand what might be causing these symptoms? Is it possible that they are related to autonomic nervous system dysfunction or a psychological condition? Which specialty should I consult for further evaluation?

Niming, 20~29 year old female. Ask Date: 2020/10/28

Dr. Jiang Junyi reply Neurology

Hello: Your symptoms may suggest hyperventilation syndrome.
Hyperventilation leads to a decrease in carbon dioxide levels in the blood, resulting in an increased pH, a condition known medically as "respiratory alkalosis." This can cause systemic reactions and symptoms, with common manifestations including vasoconstriction and hypocalcemia.
The reduced blood flow to the brain due to vasoconstriction can lead to dizziness, numbness (especially around the lips and in the upper limbs), and weakness.
In more severe cases, symptoms may escalate to agitation, hallucinations, and even seizures or fainting.
Hypocalcemia 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.
Mouth breathing can cause dry mouth, and sometimes air may enter the gastrointestinal tract, resulting in bloating and belching.
"Hyperventilation syndrome" can be classified into acute and chronic forms, with the exact etiology remaining unclear.
It is generally more prevalent in younger individuals (ages 15-55), with a higher incidence in females compared to males (7:1).
During acute episodes, there is typically noticeable rapid and deep breathing, and other related symptoms are more pronounced, leading patients to seek emergency care, making diagnosis easier.
Unfortunately, the majority of patients fall into the chronic category, making it difficult to recognize the signs of increased or deepened breathing.
They often present with chest pain and shortness of breath in thoracic clinics, and due to diagnostic challenges, they may endure painful examinations.
It is advisable for you to consult a neurologist to discuss further evaluation and treatment.
Wishing you good health, peace, and joy.
Dr.
Jiang from Taoyuan Medical Center cares about you.

Reply Date: 2020/10/28

More Info

The symptoms you are experiencing, including the sensations of numbness and tingling in various parts of your body, as well as discomfort in your chest area, can be quite concerning. It is essential to understand that these symptoms can arise from a variety of causes, and determining the underlying issue is crucial for appropriate management.

Possible Causes
1. Nerve Compression or Irritation: Conditions such as cervical radiculopathy (where a nerve in the neck is compressed) can lead to tingling sensations in the arms, hands, and even the face. Similarly, thoracic outlet syndrome can cause symptoms in the upper body due to nerve compression.

2. Circulatory Issues: Poor circulation can lead to numbness and tingling, particularly if there are vascular issues affecting blood flow to the extremities. This could be related to conditions such as peripheral artery disease.

3. Anxiety and Stress: Psychological factors can manifest physically. Anxiety can lead to hyperventilation, which may cause sensations of tingling and numbness, particularly in the face and extremities. It can also lead to chest discomfort, which may be mistaken for cardiac issues.

4. Autonomic Nervous System Dysfunction: Dysautonomia, a condition where the autonomic nervous system does not function properly, can lead to symptoms such as dizziness, faintness, and abnormal sensations throughout the body.

5. Vitamin Deficiencies: Deficiencies in vitamins such as B12, B1, or B6 can lead to neurological symptoms, including tingling and numbness.

6. Cardiac Issues: Given your history of mitral valve prolapse and the recent chest discomfort, it is essential to consider that some of your symptoms could be related to cardiac issues. While your previous tests were normal, it may be worthwhile to follow up with a cardiologist if symptoms persist.

When to Seek Help
You should seek medical attention if:
- The numbness and tingling are persistent or worsening.

- You experience weakness in your limbs.

- There are changes in your vision or speech.

- You have difficulty breathing or chest pain that feels different from your usual symptoms.

- You experience any new neurological symptoms, such as confusion or severe headaches.

Recommended Specialists
Given the complexity of your symptoms, it may be beneficial to consult with the following specialists:
- Neurologist: For further evaluation of your neurological symptoms, especially since you have already undergone some tests. A neurologist can help rule out conditions like multiple sclerosis or peripheral neuropathy.

- Cardiologist: To address your heart-related symptoms and ensure that there are no underlying cardiac issues contributing to your discomfort.

- Psychiatrist or Psychologist: If anxiety or stress is suspected to be a contributing factor, a mental health professional can provide support and treatment options.

Conclusion
Your symptoms are multifaceted and could stem from a combination of physical and psychological factors. It is essential to continue working with your healthcare providers to explore these possibilities. Keeping a symptom diary, noting when symptoms occur and any potential triggers, can be helpful for your doctors in diagnosing the issue. Remember, early intervention is key to managing any underlying conditions effectively.

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