[41F] Experiencing numbness and tingling in arm and hand with history of neuropathy

Patient Description

A 41-year-old female reports experiencing numbness and a tingling sensation in her right arm and hand, which has been particularly bothersome today, affecting her ability to perform tasks. This issue is accompanied by increased drooling while speaking, a symptom present for a few months. The patient has a history of four different types of neuropathy, migraines, colitis, transient ischemic attacks (TIA's), and depression, with these conditions being managed since 2018. Recent symptoms also include throbbing pain in the legs, particularly in the lower thighs and knees, which has been present for about a week, disturbing sleep and not alleviated by massage or walking. The patient is currently on medications including Carbamazepine, Ajovy, Topiramate, acid reflux medication, Viberzi, Sertraline (50 and 100 mg), a probiotic, Famotidine, and a hair, skin, and nails supplement. Notable allergies include reactions to Duloxetine, Sumatriptan, and Albuterol. The patient's symptoms today may be related to her neuropathy but are notably severe, warranting further medical evaluation.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Peripheral Neuropathy: Given your history of neuropathy, the numbness and tingling in your arm and hand could be related to this condition. Peripheral neuropathy often causes weakness, numbness, and pain, usually in your hands and feet. It can also affect other areas of your body.

    • Treatment typically involves managing the condition causing your neuropathy. In some situations, over-the-counter pain relievers can help. Other times, your doctor might recommend prescription medications or therapies.
  • Carpal Tunnel Syndrome: This condition is characterized by numbness, tingling, and weakness in the hand due to pressure on the median nerve in your wrist. The symptoms you described in your hand could be related to this condition.

    • Treatment typically involves avoiding activities that worsen symptoms, wearing a wrist splint, and taking over-the-counter pain relievers. Severe cases may require surgery.
  • Bulbar Palsy: This condition affects the muscles that control speech, swallowing, and other functions. The increased drooling you mentioned could be related to this condition.

    • Treatment typically involves managing symptoms and may include speech therapy, physical therapy, and medications.
  • Leg Pain: There are many potential causes for the throbbing pain in your legs. It could be related to your neuropathy, or it could be due to a separate condition such as peripheral artery disease, a blood clot, or a nerve issue.

    • Treatment will depend on the underlying cause and may include medication, physical therapy, or other interventions.

Please note that these are potential explanations based on the information you provided, and it's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Schedule an appointment with your healthcare provider to discuss your symptoms. They may want to adjust your current treatment plan or explore other potential causes for your symptoms.
  2. Try to avoid activities that worsen your hand and arm symptoms. If possible, take frequent breaks during activities that involve your hands.
  3. Stay hydrated and maintain a balanced diet. This can help manage your symptoms and overall health.
  4. Continue taking your prescribed medications as directed by your healthcare provider.

What you should look out for

Seek immediate medical attention if:

  • Your symptoms worsen significantly or suddenly
  • You experience severe pain
  • You have difficulty speaking or swallowing
  • You experience changes in your vision or severe headaches
  • You have weakness or numbness on one side of your body

Remember, I'm an AI and this advice is based on the information you provided. It's always important to consult with a healthcare provider for an accurate diagnosis and treatment.

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9 mo ago

People Also Ask


What are the common symptoms of peripheral neuropathy?

Common symptoms of peripheral neuropathy include numbness, tingling, and pain in the hands and feet, as well as weakness and sensitivity to touch. It can also affect other areas of the body.


How is carpal tunnel syndrome diagnosed and treated?

Carpal tunnel syndrome is diagnosed through a physical examination and tests such as nerve conduction studies. Treatment may involve wrist splints, avoiding activities that worsen symptoms, pain relievers, and in severe cases, surgery.


What are the potential causes of increased drooling in adults?

Increased drooling in adults can be caused by conditions affecting the muscles that control speech and swallowing, such as bulbar palsy, neurological disorders, or side effects of medications.


What could be causing throbbing leg pain and how is it treated?

Throbbing leg pain can be caused by neuropathy, peripheral artery disease, blood clots, or nerve issues. Treatment depends on the cause and may include medication, physical therapy, or other interventions.


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1 Comments


Leo#3962

9 mo ago

Given your history of TIAs at a young age, I think it might be worth getting a new medical evaluation if you haven't already. Some tests that will be relevant:

  1. An ultrasound of the leg with the throbbing pain to see if there is a blood clot (called a DVT)
  2. After a neurological physical exam, a head MRI might be helpful to see if you have had a mini-stroke recently. This is not likely, but moreso just in case to see if your mediation regimen needs to be changed
  3. If you haven't already had one, an ultrasound of your heart can see if you have a small hole (called a PFO that is present in some people after birth) that makes it more likely for blood clots to get past your heart and go to the brain

Again, most of this testing may not be needed and will probably be negative, but just wanted to let you know what can be done to rule out the scary things!

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