Nerve Issues: From Tingling Limbs to Facial Symptoms

Numbness starting from the limbs to the face?

Hello, I recently discovered that I often wake up with numbness in both arms while sleeping.
Last week, I noticed that my left leg started to feel numb, followed by my right leg, both hands, and my scalp, which have been alternating in numbness.
I went to the emergency department of a hospital and informed them that I have a diabetes issue (with fasting blood sugar levels around 130-140).
The doctor immediately attributed it to blood sugar problems and prescribed painkillers and sleeping pills without conducting any tests.
However, after a few days, the numbness increased to include my left cheek and lips, and today it has spread to the area around my eyes.
I visited another hospital, and they said it doesn't seem to be related to blood sugar issues.
I would like to ask what my symptoms are more indicative of, and which specialty I should consult? Thank you.

Sumi, 30~39 year old female. Ask Date: 2021/06/24

Dr. Jiang Junyi reply Neurology

Dear Ms.
Sumi,
Regarding the issue of sensory abnormalities you mentioned, since your symptoms are atypical, a comprehensive evaluation is recommended.
Sensory nerve abnormalities can occur in various conditions and are generally classified as symmetrical or unilateral.

In symmetrical cases, both sides of the body may experience numbness or insensitivity, with potential causes including diabetes, chemotherapy, or vitamin B12 deficiency.
In unilateral cases, considerations may include cerebrovascular diseases or spinal nerve root compression.
If peripheral neuropathy is caused by nerve compression, the following characteristics may be present:
1.
Pain with a burning or electric shock-like quality.
2.
Symptoms with a specific band-like distribution that can be triggered by touch or pressure.
3.
Accompanied by muscle weakness or fatigue.
Peripheral nerve examinations are divided into two types: "nerve conduction studies," which are traditional tests primarily assessing large fiber nerves, and "quantitative sensory testing," which focuses on small fiber nerves, measuring sensations such as cold, heat, and pain that traditional nerve conduction studies cannot assess.
Both tests complement each other and provide a comprehensive evaluation of sensory nerve abnormalities.
I recommend that you visit a neurology outpatient clinic for further examination and follow-up.
Please ensure to practice self-protection, maintain cleanliness and disinfection, and adhere to new preventive health measures before and after your medical visits.
Thank you for your inquiry.
If you have any related questions, feel free to discuss further!
Wishing you good health and peace,
Dr.
Jiang Junyi, Taoyuan Medical Center

Reply Date: 2021/06/24

More Info

Based on your description, it appears that you are experiencing a range of neurological symptoms, including tingling and numbness in various parts of your body, particularly in your arms, legs, and face. These symptoms can be concerning, especially given your history of diabetes, which can lead to neuropathy and other complications.

Understanding Your Symptoms
1. Tingling and Numbness: The sensations you are experiencing, such as tingling and numbness, can be attributed to several potential causes. In diabetic patients, peripheral neuropathy is a common complication where high blood sugar levels damage the nerves, leading to symptoms like tingling, pain, and numbness, particularly in the extremities.

2. Facial Symptoms: The recent development of tingling in your facial area, including your lips and around your eyes, raises additional concerns. Facial nerve issues can be indicative of conditions such as Bell's palsy or other neurological disorders. It is important to note that facial nerve symptoms can sometimes be linked to systemic issues, including diabetes, but they can also arise from other causes.

3. Potential Causes: Given the combination of symptoms you described, several conditions could be considered:
- Diabetic Neuropathy: As mentioned, this is a common complication of diabetes that can cause tingling and numbness.

- Multiple Sclerosis (MS): This is a condition that affects the central nervous system and can lead to a variety of neurological symptoms, including tingling and facial symptoms.

- Vitamin Deficiencies: Deficiencies in vitamins such as B12 can lead to neurological symptoms.

- Anxiety and Stress: Sometimes, anxiety can manifest physically, leading to sensations of tingling or numbness.

Recommended Actions
1. Consult a Neurologist: Given the complexity of your symptoms, it would be prudent to see a neurologist. They can perform a thorough evaluation, including a neurological examination and potentially order tests such as nerve conduction studies or an MRI if necessary.

2. Blood Tests: It may be beneficial to have blood tests done to check your vitamin levels, thyroid function, and other metabolic parameters. This can help rule out deficiencies or other underlying conditions.

3. Manage Blood Sugar Levels: Since you have diabetes, it is crucial to manage your blood sugar levels effectively. High blood sugar can exacerbate neuropathic symptoms, so working with your healthcare provider to optimize your diabetes management is essential.

4. Keep a Symptom Diary: Documenting when your symptoms occur, their duration, and any potential triggers can provide valuable information to your healthcare provider.

5. Consider Lifestyle Changes: Incorporating regular exercise, a balanced diet, and stress management techniques can also be beneficial for overall nerve health and diabetes management.

Conclusion
Your symptoms warrant a comprehensive evaluation by a healthcare professional, particularly a neurologist, to determine the underlying cause and appropriate treatment. Early intervention can significantly improve outcomes, especially in cases of neuropathy or other neurological conditions. Please take your symptoms seriously and seek medical attention promptly to ensure you receive the care you need.

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