Multiple Numbness: When to Seek Medical Advice

Numbness in multiple areas of the body?

Hello Doctor: I have been experiencing facial numbness for a year, and both EEG and facial nerve examinations showed no issues.
This month, I also started to feel numbness in my calves.
The numbness feels similar to how a person's scalp might feel, without any significant facial drooping or inability to walk due to severe numbness.
Additionally, I have persistent upper back pain and chest pain, along with a sensation of my throat being constricted.
Sometimes, I also feel short of breath and need to take deep breaths to alleviate it, but examinations have ruled out gastroesophageal reflux disease.
Lastly, I occasionally experience soreness on both sides of my forehead and upper neck, which also causes my lumbar region to ache to the point where I cannot bend over.
Given these three issues, could you please advise me on which specialty I should consult? What tests should I undergo to identify the underlying cause? Thank you for your guidance!

En, 30~39 year old female. Ask Date: 2014/05/18

Dr. Wu Fangcan reply Family Medicine

Polymyositis and dermatomyositis cannot be ruled out; consultation with rheumatology and psychiatry is recommended.
For lower back pain, ankylosing spondylitis should be considered, and rheumatology can provide a diagnosis.

Reply Date: 2014/05/18

More Info

When experiencing multiple numbness and associated symptoms, it’s essential to approach the situation methodically to determine the underlying cause and appropriate treatment. Your description of facial numbness persisting for a year, along with the recent onset of calf numbness, back pain, chest pain, and a sensation of tightness in the throat, raises several considerations.

Firstly, the numbness you describe can be attributed to various conditions, including neurological disorders, musculoskeletal issues, or even anxiety-related symptoms. Given that your brain wave and facial nerve tests have returned normal results, it suggests that there may not be an acute neurological issue, but it does not rule out other potential causes.

When to Seek Medical Advice
You should seek medical advice if:
1. Symptoms Persist or Worsen: If the numbness continues to spread or intensifies, it’s crucial to consult a healthcare professional.

2. New Symptoms Develop: The emergence of new symptoms, such as weakness, difficulty walking, or changes in vision, warrants immediate evaluation.

3. Impact on Daily Life: If the numbness or associated symptoms interfere with your daily activities or quality of life, it’s time to seek help.

Recommended Specialists
Given your symptoms, the following specialists may be appropriate for consultation:
- Neurologist: A neurologist specializes in disorders of the nervous system and can conduct further tests, such as MRI or nerve conduction studies, to evaluate potential neurological causes of your symptoms.

- Rheumatologist: If there is a suspicion of an autoimmune condition, a rheumatologist can assess for conditions like multiple sclerosis or other inflammatory disorders.

- Orthopedic Specialist or Physical Medicine and Rehabilitation (PM&R): If musculoskeletal issues are suspected, these specialists can evaluate your spine and musculoskeletal system, particularly given your back pain and tightness.

Suggested Diagnostic Tests
To identify the underlying cause of your symptoms, the following tests may be recommended:
1. MRI of the Brain and Spine: This imaging can help identify any structural abnormalities, lesions, or signs of multiple sclerosis.

2. Electromyography (EMG) and Nerve Conduction Studies: These tests can assess the electrical activity of your muscles and the speed of nerve conduction, helping to identify nerve damage or dysfunction.

3. Blood Tests: Comprehensive blood work can rule out metabolic or autoimmune conditions that may contribute to your symptoms.

4. Chest X-ray or CT Scan: Given your chest pain and sensation of tightness, imaging of the chest may be warranted to rule out any pulmonary or cardiac issues.

Conclusion
In summary, while your symptoms may not indicate an immediate life-threatening condition, they are concerning enough to warrant further investigation. It is advisable to consult a neurologist first, as they can provide a comprehensive evaluation and guide you through the necessary tests. Depending on the findings, referrals to other specialists may be necessary. Remember, early diagnosis and intervention can significantly improve outcomes, so do not hesitate to seek medical advice.

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