Right-Sided Numbness: When to Seek Further Medical Evaluation

Numbness in the right hand and right side of the body?

Hello doctor, last week I started experiencing mild numbness in the tips of my fingers.
I visited a neurologist who prescribed medication, but a few days later the numbness worsened, and soon my entire palm began to feel numb, getting progressively worse each day.
I also experienced pain in my neck.
By last Friday, I noticed that the right side of my body started to feel numb as well.
I suspect it might be a cervical spine issue compressing a nerve, so I hurried to see an orthopedic specialist who took X-rays.
I also underwent traction therapy that day, but there was no improvement, and the doctor indicated that the cervical spine X-rays appeared normal.
By the weekend, I even felt slight numbness in the front of both feet (not sure if it's just my imagination).
Doctor, which specialty should I consult next? Should I go to a major hospital for an MRI? The neurologist mentioned that it is unusual to have numbness on the right side of the body, which has made me quite anxious.
Thank you for your response.

james, 20~29 year old female. Ask Date: 2022/04/25

Dr. Jiang Junyi reply Neurology

Dear Mr.
Jame,
You mentioned that after visiting the neurology department and receiving medication, you experienced increasing numbness over the following days.
The doctor indicated that the cervical spine X-ray showed no abnormalities, but by the weekend, you even felt slight numbness in the front of both feet (unsure if this is just a perception).

The numbness you described can be assessed clinically from both a functional and neurological distribution perspective.
To evaluate the extent and type of nerve injury, additional tests such as nerve conduction studies and needle electromyography (EMG) are typically arranged.
These tests help determine if there is a slowing of nerve conduction velocity or nerve conduction block.
MRI is primarily used to rule out any structural abnormalities and is usually paired with EMG to assess correlation.
If your numbness is rapidly extending upwards, acute demyelinating polyneuropathy should be considered, as this is classified as a neurological emergency.
The classic clinical symptoms of this condition include bilateral, symmetric, progressive weakness, limb pain, and tingling or mild sensory abnormalities in the hands and feet.
These symptoms may gradually worsen over a period of days to four weeks, and in severe cases, can affect the nerves in the head and neck or the muscles responsible for breathing and swallowing.
It is essential to seek emergency medical care if this occurs.
If the condition is relatively stable, I recommend consulting a neurologist specializing in peripheral nerves, as they typically have more experience with EMG diagnostics.
Thank you for your inquiry, and I welcome further discussion.
Wishing you good health, safety, and happiness.
Dr.
Jiang Junyi, Neurologist, Taoyuan Hospital

Reply Date: 2022/04/25

More Info

It sounds like you are experiencing a concerning set of symptoms that have progressively worsened over the past week. The numbness in your fingers, hand, and now extending to the right side of your body, along with neck pain, could indicate a neurological issue that requires further evaluation. Here’s a breakdown of your situation and some recommendations on how to proceed.

Understanding Your Symptoms
1. Numbness and Tingling: The numbness you initially felt in your fingers, which has now spread to your hand and right side, could be due to several factors, including nerve compression, cervical spine issues, or even systemic conditions. The fact that it is worsening is particularly concerning.

2. Neck Pain: The accompanying neck pain suggests that there may be an issue in the cervical spine, such as a herniated disc or cervical radiculopathy, which can compress nerves and lead to numbness in the arms and potentially the legs.

3. Progression to Lower Extremities: The development of numbness in your legs is alarming and could indicate that the issue is not localized to the cervical spine but may involve broader neurological pathways.

When to Seek Further Evaluation
Given the progression of your symptoms, it is crucial to seek further medical evaluation. Here are some steps you should consider:
1. Consult a Neurologist: Since your symptoms are neurological in nature, a neurologist is well-equipped to evaluate your condition. They can perform a thorough neurological examination and may recommend additional tests such as an MRI of the cervical spine to assess for any structural abnormalities that could be compressing nerves.

2. MRI Imaging: An MRI is a non-invasive imaging technique that provides detailed images of the spine and surrounding tissues. It is particularly useful for identifying herniated discs, spinal stenosis, or other conditions that may not be visible on X-rays. Given your symptoms and the lack of findings on X-ray, an MRI is warranted.

3. Physical Therapy: While awaiting further evaluation, physical therapy may help alleviate some symptoms, especially if there is a muscular component contributing to your discomfort. However, this should be guided by a healthcare professional who understands your specific condition.

4. Emergency Care: If you experience any sudden changes such as loss of bladder or bowel control, severe weakness, or difficulty walking, seek emergency medical attention immediately, as these could be signs of a more serious condition.

Conclusion
In summary, your symptoms warrant further investigation, particularly with an MRI to rule out any serious underlying conditions. Consulting a neurologist will provide you with a comprehensive evaluation and appropriate management plan. It’s essential to address these symptoms promptly to prevent potential complications and to ensure that you receive the best possible care. Remember to keep a record of your symptoms, including when they started and how they have progressed, as this information will be valuable for your healthcare provider.

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