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Forum Name: Neurology Topics

Question: Isolated Forearm paresthesia


 uninsuredinCT - Tue Nov 04, 2008 1:50 am

Hi:

I'm experiencing a kind of odd paresthesia at a point in my right forearm approximately 2 and 1/2 to 3 inches from the wrist, near dead center of the topside of the forearm. This has been persistant for approximately a week or so.

Depending on arm movement, a feeling of burning (or more accurately hair-pulling-out) occurs at that spot, varying in intensity dependent upon the accompanying movement.

When not moving to trigger the sensation, pressure on the spot from a finger press results in an indeterminate *strange* feeling, somewhere between numbness/pins & needles and bruise-ache. The affected are seems to be approximately a fingerprint's diameter or so.

The triggering movement or posture seems to include any downward reaching with fingers extended, with the proviso that the reaching involves a slight shoulder extension. Reaching to the side produces the sensation more than reaching directly out. Reaching with a fist lessens the degree of the burning/pulling in that one nerve spot, but does not make it completely disappear.

There is no (seeming) hand, finger or wrist pain or loss of strength,no sense of carpal tunnel as I have seen it in office co-workers. Flexing of fingers or fanning does not seem to trigger the acute nerve-weirdness; it seems to occur mostly with extension and angle.

Things that I suspect:

I have been using a Lenovo thinkpad recently with more frequency.The pointing device is the mid-kepyboard "nipple" micro-joystick, operated with the right index finger. Analog pressure in various directions, along with a thumb pressure downward for clicking are combined in what is probably an increasingly repetitive motion as I use the compute more.

I don't know if this odd and unusual hand posture would produce such an acute result without other, more traditional repetitive stress injury?

Also, and this is what is making me a bit nervous: 2 years ago, I had what seemed to be meralegia paresthetica in my right upper thigh; a saucer-sized patch of numbness. At the time, I was dangerously overweight.

I had also experienced, previous to that symptom, some troubling bouts of bladder voiding; the feeling that the bladder was never truly voided, and the need to "dribble" or keep on squirting small amounts every other minute. These incidents were episodic. Years previous, I had had a few recurring instances of very small kidney stones which produced similar(ish) symptoms. All stones passed by themselves,some with no outward indication other than a cessation of discomfort. (i.e. no visible pee-blood.)

ALL of these symtoms went away after I lost approximately 90lbs and engaged in continued and sustained strength training and exercise, and adopted a diet rich in both dietary fiber and specifically rich in cruciferous vegetables (broccolli, kale, brussel sprouts, cauliflower,etc.) and antioxidant oils (flax, cold-pressed olive)

Here's the thing: I was concerned, when the meralegia parestherica appeared, that it may be MS, as I have an uncle who had adult-onset MS.

But no motor indications of MS were present, no balance issues or knee-tap problems; the more likely (and shameful) explanation was that I had eaten myself into a neurological disorder by way of tight pants and extended sitting, both at a desk and long commute.

Some reading indicated that diet and exercise would be helpful in EITHER case; MS or just obesity-induced nerve pressure, so I embarked on a weight loss/lifestyle change.

After losing the weight, and the symtoms disappeared, I had figured that the on-again-off-again bladder voiding issue could well have been a slight stone recurrance, and just an unfortunate coincidence making a seeming (but misleading) symptom cluster to suggest possible MS.

And now, too, what would appear to a layman like me as an Occam's Razor solution (the trac-button/analog-stick pointing device in the keyboard causing a nerve-something-or-other), what with it being only in one spot and on one side and without other symptoms is still troubling, with the hanging "?" that comes up anytime a nerve is misreporting to the brain.

At long (LONG, LONG) last, here's my question: I'm uninsured after a job loss and in the process of trying to get on my wife's insurance. I MAY have to wait for her open enrollment period, which is in December, but I may be able to get on sooner.

Based on what I've told you,as a neurologist, would you recommend me seeking immediate scanning/treatment, or is it safe to wait 'till December if I have to?

I worry too,since I am a layman, that this symptom may indicate something totally out of left field that a specialist would be able to diagnose (or at least suspect and test for) immediately. Like, is this possibly a tumor? (There's no visible lump,but there is clearly something neurological at play,no?) I'm heartened by the fact that it seems so mechanical; move my arm THIS way,and it "fires," but then I think, maybe that's also the case with a tumor or cyst or whatever.

In any case, what does it sound like to you and what would you recommend I do?
 John Kenyon, CNA - Tue Dec 16, 2008 9:55 pm

User avatar Hello -

First, I am not a neurologist, but am trying to pick up the unanswered questions here. I'm not even an MD. However, I am a very experienced, multi-skilled technician.

Second of all, congratulations on the remarkable weight loss and resultant improvement in health. That in itself is quite an achievment.

Now then: the symptom you describe is, of course, at least partly neurological, in that nerve is involved and affected. However, we'd hardly know anything was going on with our bodies were it not for some nerve involvement. The question is: Does the problem originate with the nerve or is it being affected from some central location? Since the sensation, odd as it is, may be predictably triggered by certain specific movements of the hand/forearm, and more importantly, because of the repetitive motion issue you mention (and the specific make of computer in particular, which offers somewhat less support at the front of the keyboard than many other makes and types), it seems most likely this is a work-related problem. It isn't that great a problem, of course, but if it were to represent a potential central nervous lesion then it would cause a good deal of worry. The fact that it can be triggered predictably by certain mechanical maneuvers, plus the insightful mention of the brand and model of laptop you use strongly suggest a repetitive motion complaint (if not injury).

I hope this is helpful. You've done a great job with improving your overall health, and I can well understand, due to having a history of neurological problems that were weight-related, that you'd be more sensitive to this sort of symptom, but objectively it is almost certainly a mechanical one. Best of luck to you.

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