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Forum Name: Neurology Topics

Question: Temporary Hand Paralysis During Veinous Ablation procedure


 1972redhead - Sat Apr 18, 2009 3:07 pm

Yesterday, I went in to have veinous ablation performed on my right saphenous vein. Once the catheter was inserted at the knee it was quite painfully moved up to the groin area. A wire was then placed in the catheter. I was not looking down at it, but had the sensation quickly of nausea, rapid breathing, sweating and thirst. I felt pressure move up to my chest, neck and up the back right side of my head. The nausea increased and I told the doctor what I was feeling. He told me to just stay calm.All of a sudden, my hands started 'tightening up', until they were bending upwards, thumbs included. I could not move them. I could use my arms to shake my hands, trying to 'shake it out', but they stayed tightly as they were and wouldn't move. Meanwhile, both legs went numb. Upon seeing my hands, the doctor said he had never seen that happen and pulled everything out. About a minute after everything was out, I continued to shake my hands and they finally relaxed and went back to normal and I could feel them! Feeling came back in my legs too. He wheeled me down in a wheelchair to ER where I waited an hour to have a doctor give me no tests and tell me I must've had an anxiety attack. I don't think I could consciously position my hands in the frozen, curled up position they had been in, had I tried... but since they had no other explanation, they chalked it up to 'anxiety'. Today, I still have a headache on the right side of my head, but since they did not deem it necessary to even do a CAT/MRI in ER...I'm not rushing out to another ER. Plus, no paralysis has repeated itself. I just feel like I got run over by a truck today. MY personal opinion is that something hit a nerve. I suggested that to the doctor, but he said that was impossible. Any thoughts??
 John Kenyon, CNA - Thu Apr 30, 2009 8:55 pm

User avatar Hello --

I can think of two possible causes of this response, and one of them, the more readily accepted one (and which, oddly, fits the description here) would be a by-product of anxiety. The other is something else I'll get into in a moment.

The procedure can be painful and can definitely touch nerves. However, anxiety oven supervenes in these situations and panic, often compeletely outside the awareness of the patient, can cause displacement behavior such as unwitting hyperventilation, which in turn can cause very profound hand paralysis/spasm such as you describe (I have seen this many times, it is a well-known, readily recognized, very old phenomenon called carpal spasm and is directly related to faulty breathing patterns in people who are anxious and/or stressed). This procedure could be considered a sort of emotional stress test for some people, so there's that possibiiltiy.

There is also the theoretical retrograde neurological response, but this would have had to involve the spinal cord, which was not touched during your ordeal. On the other hand you mention rapid breathing, which definitely would explain the hand spasms even if you felt or were aware of no frank anxiety (and people who have anxiety attacks, especially first time, generally will deny any such thing is going on, which is not unreasonable, since they aren't really aware of it).

I hope this answers your question. I'm sorry the procedure went as it did, and it was probably pain that led you into the hyperventilation, but I'm fairly certain this is what casued your hand spasms.

Good luck to you and please feel free to follow up with us here as needed.

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