Migraines and Hand Numbness: When to Seek Help

Migraine and hand numbness?

Dear Dr.
Chuang,
Hello! I am a 25-year-old female, 174 cm tall and weighing 70 kg.
I have a history of migraines (on the left side of my head) since middle school, and recently they have become more severe (over the past two months).
Additionally, I wake up every morning with numbness in both of my forearms, and sometimes I wake up at night due to the numbness, interrupting my sleep.

I would like to ask you:
1.
Could this be a warning sign of a potential blockage in the brain's blood vessels?
2.
Should I go to the hospital for a CT scan or other detailed examinations?
Thank you, Dr.
Chuang, for taking the time to answer my questions amidst your busy schedule.
I appreciate it!

Xiao Mei, 20~29 year old female. Ask Date: 2007/07/08

Dr. Zhuang Yumin reply Neurology

Dear Xiaomei,
Most migraines are benign, with only a small number associated with vascular malformations in the brain.
If the headache is accompanied by limb weakness or seizures, further examination is necessary; otherwise, medication treatment can be prioritized.
In fact, the frequency and intensity of migraine attacks are related to stress and emotions, so maintaining a regular routine and a positive mood is also very important.

As for the symptoms of numbness in both forearms upon waking up each morning, this is mostly caused by ulnar nerve compression in the arms, generally related to poor sleeping posture.
There is no need to be overly anxious, but if the condition worsens, a nerve conduction study should be performed.
Sincerely,
Dr.
Chuang Yu-Min
Director of Neurology, Taoyuan Hospital, Department of Health

Reply Date: 2007/07/08

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding your migraines and the recent onset of hand numbness. It’s important to address these symptoms, especially given your history of migraines and the new development of numbness in your hands.

1. Understanding Your Symptoms: Migraines can be associated with various neurological symptoms, including sensory disturbances like numbness or tingling. The fact that you are experiencing numbness in both forearms, particularly upon waking, raises some concerns. While it is not uncommon for migraines to cause temporary neurological symptoms, the persistent nature of your hand numbness, especially if it disrupts your sleep, warrants further investigation.
2. Potential Causes: The numbness in your hands could be related to several factors. One possibility is that it may be due to positional issues during sleep, such as compression of nerves in the arms or neck. However, given your history of migraines, it is also essential to rule out more serious conditions, such as vascular issues or neurological disorders. The numbness could be a sign of nerve compression (like carpal tunnel syndrome) or even cervical spine issues, which can sometimes manifest as arm numbness.

3. When to Seek Help: Given the combination of worsening migraines and new neurological symptoms, it is advisable to seek medical attention promptly. While not all cases of migraines with numbness indicate a severe underlying issue, the persistence and nature of your symptoms suggest that further evaluation is necessary.
4. Recommended Investigations: A CT scan or MRI of the brain may be warranted to rule out any structural abnormalities, especially if your migraines have changed in frequency or intensity. Additionally, a thorough neurological examination can help assess your symptoms more accurately. Your healthcare provider may also consider blood tests to check for any underlying conditions that could contribute to your symptoms, such as vitamin deficiencies or thyroid issues.

5. Next Steps: I recommend scheduling an appointment with a neurologist or your primary care physician as soon as possible. They can perform a comprehensive evaluation and determine the appropriate imaging studies or tests needed. It’s also helpful to keep a diary of your migraine episodes, noting their frequency, duration, and any associated symptoms, including the hand numbness. This information can provide valuable insights for your healthcare provider.

In summary, while your symptoms may not necessarily indicate a severe condition, the combination of worsening migraines and new numbness in your hands should not be ignored. Seeking medical evaluation is crucial to ensure that any potential issues are addressed promptly and appropriately.
Take care, and I hope you find relief soon.

Best regards,
Doctor Q&A Teams

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