Hypoesthesia

Last updated
Hypoesthesia
Other namesNumbness, hypesthesia
Specialty Psychiatry, Neurology

Hypoesthesia or numbness is a common side effect of various medical conditions that manifests as a reduced sense of touch or sensation, or a partial loss of sensitivity to sensory stimuli. In everyday speech this is generally referred to as numbness. [1]

Contents

Hypoesthesia primarily results from damage to nerves, and from blockages in blood vessels, resulting in ischemic damage to tissues supplied by the blocked blood vessels. This damage is detectable through the use of various imaging studies. Damage in this way is caused by a variety of different illnesses and diseases. A few examples of the most common illnesses and diseases that can cause hypoesthesia as a side effect are as follows:

Diseases

Decompression sickness

Decompression sickness occurs during rapid ascent, spanning 20 or more feet (typically from underwater). Decompression sickness may express itself in a variety of ways, including hypoesthesia. Hypoesthesia results because of air bubbles that form in blood, which prevents oxygenation of downstream tissue. [2] In cases of decompression sickness, treatment to relieve hypoesthesia symptoms is quick and efficient. Hyperbaric oxygen is used to maintain long term stability, which includes breathing of oxygen at a level of 100%. [2]

Trigeminal schwannoma

Cell morphology observed in all nerve root schwannomas Nerve root schwannoma - intermed mag.jpg
Cell morphology observed in all nerve root schwannomas

Trigeminal schwannoma is a condition in which a tumor forms on the trigeminal nerve (also known as cranial nerve five). [1] This prevents sensation in the area associated with the nerve. In the case of the trigeminal nerve, this is the face, meaning hypoesthesia of the face is experienced. Excision is the only effective treatment of trigeminal schwannoma, though this may not treat the associated hypoesthesia if damage has already occurred. Following surgery, many patients still experienced hypoesthesia and some even experienced increased effects. [1]

Rhombencephalitis

Rhombencephalitis involves bacterial invasion of the brainstem and trigeminal nerve, and has a wide variety of symptoms that may vary between patients. [3] Similarly to the trigeminal schwanonoma mentioned above, this can result in facial hypoesthesia. Rhombencephalitis may also result in hypoesthesia of the V1 through V3 dermatomes. [3] The main treatment option for this infection is antibiotics, [4] such as ampicillin, to remove the bacteria.

Intradural extramedullary tuberculoma of the spinal cord (IETSC)

IETSC is a cancer of the spinal cord that involves hypoesthesia of all parts of the body associated with the affected spinal nerves. [5] The inability to convey information from the body to the central nervous system will cause a total lack of feeling in the associated regions.[ citation needed ]

Cutaneous sensory disorder

Hypoesthesia is one of the negative sensory symptoms associated with cutaneous sensory disorder (CSD). In this condition, patients have abnormal disagreeable skin sensations that can be due to increased nervous system activity (stinging, itching or burning) or decreased nervous system activity (numbness or hypoesthesia). [6]

Beriberi

Hypoesthesia originating in (and extending centrally from) the feet, fingers, navel, and/or lips is one of the common symptoms of beriberi, [7] which is a set of symptoms caused by thiamine deficiency.

Diagnosis

A patient experiencing symptoms of hypoesthesia is often asked a series of questions to pinpoint the location and severity of the sensory disruption. A physical examination may follow where a doctor may tap lightly on the skin to determine how much feeling is present. Depending upon the location of the symptoms occurring, a doctor may recommend some tests to determine the overlying cause of the hypoesthesia. These tests include imaging computerized axial tomography (CT) and magnetic resonance imaging (MRI) scans, nerve conduction studies to measure electrical impulses passing through the nerves in search of damage to the nerves, and various reflex tests. [2] An example of a reflex test would be the patellar reflex test.[ citation needed ]

Treatment

Treatment of hypoethesia are aimed at targeting the more broad disease or illnesses that has caused the side effect of sensation loss. [1] [2] [3] [4]

See also

Related Research Articles

<span class="mw-page-title-main">Cranial nerves</span> Nerves that emerge directly from the brain and the brainstem

Cranial nerves are the nerves that emerge directly from the brain, of which there are conventionally considered twelve pairs. Cranial nerves relay information between the brain and parts of the body, primarily to and from regions of the head and neck, including the special senses of vision, taste, smell, and hearing.

<span class="mw-page-title-main">Trigeminal nerve</span> Cranial nerve responsible for the faces senses and motor functions

In neuroanatomy, the trigeminal nerve (lit. triplet nerve), also known as the fifth cranial nerve, cranial nerve V, or simply CN V, is a cranial nerve responsible for sensation in the face and motor functions such as biting and chewing; it is the most complex of the cranial nerves. Its name (trigeminal, from Latin tri- 'three', and -geminus 'twin') derives from each of the two nerves (one on each side of the pons) having three major branches: the ophthalmic nerve (V1), the maxillary nerve (V2), and the mandibular nerve (V3). The ophthalmic and maxillary nerves are purely sensory, whereas the mandibular nerve supplies motor as well as sensory (or "cutaneous") functions. Adding to the complexity of this nerve is that autonomic nerve fibers as well as special sensory fibers (taste) are contained within it.

<span class="mw-page-title-main">Somatic nervous system</span> Part of the peripheral nervous system

The somatic nervous system (SNS) is made up of nerves that link the brain and spinal cord to voluntary or skeletal muscles that are under conscious control as well as to skin sensory receptors. Specialized nerve fiber ends called sensory receptors are responsible for detecting information within and outside of the body.

Decompression Illness (DCI) comprises two different conditions caused by rapid decompression of the body. These conditions present similar symptoms and require the same initial first aid. Scuba divers are trained to ascend slowly from depth to avoid DCI. Although the incidence is relatively rare, the consequences can be serious and potentially fatal, especially if untreated.

<span class="mw-page-title-main">Peripheral neuropathy</span> Nervous system disease affecting nerves beyond the brain and spinal cord

Peripheral neuropathy, often shortened to neuropathy, refers to damage or disease affecting the nerves. Damage to nerves may impair sensation, movement, gland function, and/or organ function depending on which nerve fibers are affected. Neuropathies affecting motor, sensory, or autonomic nerve fibers result in different symptoms. More than one type of fiber may be affected simultaneously. Peripheral neuropathy may be acute or chronic, and may be reversible or permanent.

Spinal tumors are neoplasms located in either the vertebral column or the spinal cord. There are three main types of spinal tumors classified based on their location: extradural and intradural. Extradural tumors are located outside the dura mater lining and are most commonly metastatic. Intradural tumors are located inside the dura mater lining and are further subdivided into intramedullary and extramedullary tumors. Intradural-intramedullary tumors are located within the dura and spinal cord parenchyma, while intradural-extramedullary tumors are located within the dura but outside the spinal cord parenchyma. The most common presenting symptom of spinal tumors is nocturnal back pain. Other common symptoms include muscle weakness, sensory loss, and difficulty walking. Loss of bowel and bladder control may occur during the later stages of the disease.

Neuralgia is pain in the distribution of a nerve or nerves, as in intercostal neuralgia, trigeminal neuralgia, and glossopharyngeal neuralgia.

<span class="mw-page-title-main">Neurofibromatosis type II</span> Type of neurofibromatosis disease

Neurofibromatosis type II is a genetic condition that may be inherited or may arise spontaneously, and causes benign tumors of the brain, spinal cord, and peripheral nerves. The types of tumors frequently associated with NF2 include vestibular schwannomas, meningiomas, and ependymomas. The main manifestation of the condition is the development of bilateral benign brain tumors in the nerve sheath of the cranial nerve VIII, which is the "auditory-vestibular nerve" that transmits sensory information from the inner ear to the brain. Besides, other benign brain and spinal tumors occur. Symptoms depend on the presence, localisation and growth of the tumor(s). Many people with this condition also experience vision problems. Neurofibromatosis type II is caused by mutations of the "Merlin" gene, which seems to influence the form and movement of cells. The principal treatments consist of neurosurgical removal of the tumors and surgical treatment of the eye lesions. Historically the underlying disorder has not had any therapy due to the cell function caused by the genetic mutation.

<span class="mw-page-title-main">Neuritis</span> Inflammation of a nerve or generally any part of the nervous system

Neuritis, from the Greek νεῦρον), is inflammation of a nerve or the general inflammation of the peripheral nervous system. Inflammation, and frequently concomitant demyelination, cause impaired transmission of neural signals and leads to aberrant nerve function. Neuritis is often conflated with neuropathy, a broad term describing any disease process which affects the peripheral nervous system. However, neuropathies may be due to either inflammatory or non-inflammatory causes, and the term encompasses any form of damage, degeneration, or dysfunction, while neuritis refers specifically to the inflammatory process.

Meralgia paresthetica or meralgia paraesthetica is pain or abnormal sensations in the outer thigh not caused by injury to the thigh, but by injury to a nerve which provides sensation to the lateral thigh.

<span class="mw-page-title-main">Schwannomatosis</span> Rare genetic disorder

Schwannomatosis is an extremely rare genetic disorder closely related to the more-common disorder neurofibromatosis (NF). Originally described in Japanese patients, it consists of multiple cutaneous schwannomas, central nervous system tumors, and other neurological complications, excluding hallmark signs of NF. The exact frequency of schwannomatosis cases is unknown, although some populations have noted frequencies as few as 1 case per 1.7 million people.

A neurectomy, or nerve resection is a neurosurgical procedure in which a peripheral nerve is cut or removed to alleviate neuropathic pain or permanently disable some function of a nerve. The nerve is not intended to grow back. For chronic pain it may be an alternative to a failed nerve decompression when the target nerve has no motor function and numbness is acceptable. Neurectomies have also been used to permanently block autonomic function, and special sensory function not related to pain.

A nerve root is the initial segment of a nerve leaving the central nervous system. Nerve roots can be classified as:

<span class="mw-page-title-main">Spinal disc herniation</span> Injury to the connective tissue between spinal vertebrae

A spinal disc herniation is an injury to the intervertebral disc between two spinal vertebrae, usually caused by excessive strain or trauma to the spine. It may result in back pain, pain or sensation in different parts of the body, and physical disability. The most conclusive diagnostic tool for disc herniation is MRI, and treatment may range from painkillers to surgery. Protection from disc herniation is best provided by core strength and an awareness of body mechanics including good posture.

Dysesthesia is an unpleasant, abnormal sense of touch. Its etymology comes from the Greek word "dys," meaning "bad," and "aesthesis," which means "sensation". It often presents as pain but may also present as an inappropriate, but not discomforting, sensation. It is caused by lesions of the nervous system, peripheral or central, and it involves sensations, whether spontaneous or evoked, such as burning, wetness, itching, electric shock, and pins and needles. Dysesthesia can include sensations in any bodily tissue, including most often the mouth, scalp, skin, or legs.

<span class="mw-page-title-main">Superior cluneal nerves</span>

The superior cluneal nerves are pure sensory nerves that innervate the skin of the upper part of the buttocks. They are the terminal ends of the L1-L3 spinal nerve dorsal rami lateral branches. They are one of three different types of cluneal nerves. They travel inferiorly through multiple layers of muscles, then traverse osteofibrous tunnels between the thoracolumbar fascia and iliac crest.

<span class="mw-page-title-main">Neurogenic claudication</span> Medical condition

Neurogenic claudication (NC), also known as pseudoclaudication, is the most common symptom of lumbar spinal stenosis (LSS) and describes intermittent leg pain from impingement of the nerves emanating from the spinal cord. Neurogenic means that the problem originates within the nervous system. Claudication, from the Latin word for to limp, refers to painful cramping or weakness in the legs. NC should therefore be distinguished from vascular claudication, which stems from a circulatory problem rather than a neural one.

<span class="mw-page-title-main">Nerve compression syndrome</span> Human disease

Nerve compression syndrome, or compression neuropathy, or nerve entrapment syndrome, is a medical condition caused by chronic, direct pressure on a peripheral nerve. It is known colloquially as a trapped nerve, though this may also refer to nerve root compression. Its symptoms include pain, tingling, numbness and muscle weakness. The symptoms affect just one particular part of the body, depending on which nerve is affected. The diagnosis is largely clinical and can be confirmed with diagnostic nerve blocks. Occasionally imaging and electrophysiology studies aid in the diagnosis. Timely diagnosis is important as untreated chronic nerve compression may cause permanent damage. A surgical nerve decompression can relieve pressure on the nerve but cannot always reverse the physiological changes that occurred before treatment. Nerve injury by a single episode of physical trauma is in one sense an acute compression neuropathy but is not usually included under this heading, as chronic compression takes a unique pathophysiological course.

<span class="mw-page-title-main">Spinal stenosis</span> Disease of the bony spine that results in narrowing of the spinal canal

Spinal stenosis is an abnormal narrowing of the spinal canal or neural foramen that results in pressure on the spinal cord or nerve roots. Symptoms may include pain, numbness, or weakness in the arms or legs. Symptoms are typically gradual in onset and improve with leaning forward. Severe symptoms may include loss of bladder control, loss of bowel control, or sexual dysfunction.

Cervical spondylotic myelopathy (CSM) is a disorder characterised by the age-related deterioration of the cervical spinal cord. Also called spondylotic radiculomyelopathy (SRM), it is a neurological disorder related to the spinal cord and nerve roots. The severity of CSM is most commonly associated with factors including age, location and extent of spinal cord compression.

References

  1. 1 2 3 4 Chen, Li-Feng; Yang, Yang; Yu, Xin-Guang; Gui, Qiu-Ping; Bu, Bo; Xu, Bai-Nan; Zhou, Ding-Biao (June 2014). "Operative management of trigeminal neuromas: an analysis of a surgical experience with 55 cases". Acta Neurochirurgica . 156 (6): 1105–1114. doi:10.1007/s00701-014-2051-7. ISSN   0942-0940. PMID   24633987. S2CID   20181528.
  2. 1 2 3 4 Moon, R. E. (March 2014). "Hyperbaric oxygen treatment for decompression sickness". Undersea & Hyperbaric Medicine. 41 (2): 151–157. ISSN   1066-2936. PMID   24851553.
  3. 1 2 3 Karlsson, William K.; Harboe, Zitta Barrella; Roed, Casper; Monrad, Jeppe B.; Lindelof, Mette; Larsen, Vibeke Andrée; Kondziella, Daniel (September 2017). "Early trigeminal nerve involvement in Listeria monocytogenes rhombencephalitis: case series and systematic review". Journal of Neurology. 264 (9): 1875–1884. doi:10.1007/s00415-017-8572-2. ISSN   1432-1459. PMID   28730571. S2CID   44481344.
  4. 1 2 Stylianos, Kapetanakis; Konstantinos, Giatroudakis; Pavlos, Pavlidis; Aliki, Fiska (July 2016). "Brachial branches of the medial antebrachial cutaneous nerve: A case report with its clinical significance and a short review of the literature". Journal of Neurosciences in Rural Practice. 7 (3): 443–446. doi: 10.4103/0976-3147.182772 . PMC   4898116 . PMID   27365965.
  5. Roca, Bernardino (June 2005). "Intradural extramedullary tuberculoma of the spinal cord: a review of reported cases". The Journal of Infection. 50 (5): 425–431. doi:10.1016/j.jinf.2004.07.012. ISSN   0163-4453. PMID   15907551.
  6. Gupta, M. A.; Gupta, A. K. (2013). "Cutaneous sensory disorder". Seminars in Cutaneous Medicine and Surgery. 32 (2): 110–8. doi:10.12788/j.sder.0010. PMID   24049969.
  7. Brooks, Henry Turner (1912). Text-book of General and Special Pathology for Students and Practitioners. F. A. Davis Company. p.  582. beriberi hypesthesia.