Numbness in hands and face, headaches, fatigue: what is this?

December 14, 2011 7:47 AM

Hi, MeFi. I've had a medical condition for the past month which involves numbness in my hands and face, headaches, fatigue, emotional distress, and other unpleasant symptoms. I know YANMD, and I am in fact already seeing a doctor and will soon be seeing a neurologist. I'm sorry about the wall of text, but if any of this sounds familiar, please let me know -- it would really help when talking to my doctors!

At the end of October, I was recovering from a very minor cold: my throat was mucousy and I was coughing a bit, but that was it. One day, I started to feel a certain numbness -- you could even call it "pins and needles" -- in my hands. It started innocuously, once every few days, usually when I was driving at night. Soon, it spread to my face and started happening with an increasing frequency, but still mostly in the evenings. The sensation was bilateral.

This didn't pass after a week, so naturally, I started to worry. I started to feel like I had the flu, and I spent a day away from work when I was feeling particularly crappy. On Monday, I went to see the doctor. My blood tests were fine, with only a minor vitamin D deficiency (which I'm taking medicine for now). I was also prescribed an MRI, just in case.

The following week, my symptoms seemed to change. I wasn't getting the pins and needles so much anymore, but I started having more headaches. In addition, whenever I woke up, my fingertips and face felt strangely numb, and I felt like it was probably related to the pins and needles. One time, I went over to a party in Berkeley. It was really stuffy, and I suddenly felt strangely ill. My face and ears were very warm to the touch and I felt a bit dizzy and disoriented, even to the point where my eyes had some trouble focusing. It was almost like I had drank too much. I just wanted to lie down somewhere, and when I did, even though I could still reason quite clearly, my emotional state was completely off: I recognized the house and my friends, but they didn't have all the emotional associations that I usually have with them, if that makes any sense. The next day, I was really tired and still a bit disoriented, and I ended up sleeping for most of it.

Then, a few days later, I suddenly felt fine. Everything was great for a while, but then I started getting a feeling of lightheadedness and slight associated nausea. For a week or two (I think), it really felt like I was alternating between the warm-faced, migrane-like state I experienced at the party, feeling good, and feeling lightheaded.

My MRI was coming up in a week, and I was completely panicking the entire time. My thoughts turned to various horrible diseases with matching symptoms I had uncovered on the internet: what if it was MS, or worse? I thought about death a lot. When I finally went to see my doctor for a followup appointment, it turned out that the MRI came back clean. Whew!

At the moment, my symptoms have transformed somewhat from their original state, but still seem related. A lot of the time, I feel okay -- not great, but okay. I often feel tired and somewhat depressed, and I don't feel like I have the energy to go out and do stuff very often. I still wake up with numb hands and face which often lasts for the entire day, and I seem to have some trouble sleeping. Then, every few days, I get that same warm-faced headache, though to a much lesser degree. (For example, I don't feel the emotional disconnect so much anymore, which is great: when it first happened, I was terrified that I was losing my mind!) I noticed that whenever it happens, my throat feels like it's burning. My skin also sometimes feels sensitive to the touch, as if it's been sunburned (but this usually passes quickly). I've experienced pain in my lower left abdomen, and I've found that I had to go to the bathroom more often than I did in the past. The original pins and needles don't reoccur so much anymore, but when they do, they're often unilateral, on my left side. And throughout all this time, I've had various flu-like symptoms, including coughing and mucous buildup in my throat.

I've been avoiding gluten for the past few days to see if I have Celiac disease -- no help, just got another headache today. And I recognize that many of my symptoms have attributes of panic attacks, which I've had one of in the past -- but I feel like too many of them are physiological to be completely caused by stress.

Any thoughts? Thank you for your time!

posted by anonymous to health & fitness (14 answers total)

A Vitamin B12 deficiency is the first thing to come to mind, but I assume you were checked for that already. But we really can't diagnose you over the internet - keep your doctor's appointments and get everything physical ruled out.

but I feel like too many of them are physiological to be completely caused by stress.

Stress and anxiety have an amazing ability to cause physical distress. But you still need to rule everything else out first before attributing your symptoms to something psychological.
posted by amro at 7:59 AM on December 14, 2011 [1 favorite]

numbness and tingling [and pain] in arms, leg, face [usually on one side] are classic sensory aura symptoms of a migraine. I say with experience. They make me feel like crap, but the headache isn't the defining feature for me (as opposed to classic migraines with the kill-me headache). They make me really tired, like have to sleep NOW tired. I don't get the very often anymore, but was on topomax for years which I found very effective.
posted by atomicstone at 8:29 AM on December 14, 2011 [3 favorites]

It could be stress and anxiety (even if you don't feel you have anything to be really stressed about).

Are you experiencing any strange digestive problems as well? One thing that comes to mind is stimulation of the vagal nerve which can cause symtoms close to what your experiencing up to out-right fainting. Try a few weeks of PPIs (like pantaprozle, zantac, etc).

Set up an appointment with an ENT doctor to check those areas. See if your mucous is infected.

I wish you the best of luck. I had something very similar happen a few years ago that took months to resolve itself. I went everywhere I could for help (including John Hopkins), but could not get any official diagnosis. The worst of it was when my body would somewhat "freeze up" unexpectedly. After a long time paying attention to how things were working...I think I narrowed my specific case down to digestive and vasal-vagal syncope. IANAD though, so your root causes may be completely different. Just pay attention to what you drink and eat, how you sleep, and what is going on in your life that "triggers" episodes. Take some time off to relax, and avoid caffiene and alcohol for awhile.
posted by samsara at 8:29 AM on December 14, 2011

The numbness, tingling, dizziness, headaches, fatigue, emotional detachment, and sensitivity to stimulation (visual, auditory, etc.) are all things I've experienced due to temporal lobe seizures, which were diagnosed in adulthood and are currently pretty well controlled by meds. I'm glad you're going to be seeing a neuro.
posted by worldswalker at 8:38 AM on December 14, 2011

IAAlsoNYD but

1. Based on my non-md opinion, I don't think your symptoms point to celiac disease, but since these days it seems more and more I hear of people not eating gluten who feel better when they've had various ailments that are improved somewhat by avoiding it, it couldn't hurt.

2. avoiding gluten for a few days is probably not going to make an initial noticeable difference if you truly had celiac disease (gluten intolerance), and you've been pegging your unfortunately sensitive intestines with it for, well, probably most of your life if you've grown up in the US. Damage to your innards due to celiac disease is cumulative. While I of course hope you have nothing serious, if you wanted to see if not eating gluten could help you, you need to avoid it like the plague and not cheat at ALL for at least a couple months, if not longer. It can be annoying at first to eat gluten free, but it's way way easier now than it has ever been, plus most people have at least heard the term even if they're not sure what "gluten" is. There are tests you can do to see if you have it, like an intestinal biopsy, or a stool test from Enterolab in Houston (though not everyone is in agreement on how accurate that is), neither of which are painful although clearly the biopsy is annoying to do.

3. Also, Samsara, my understanding of actual vagal nerve weirdness and digestion is that PPI's wouldn't help if there's truly a nerve problem - you'd need to use neurologic or motility meds. But I'm certainly no expert on the nervous system, I've just had my own weird stomach problem for the last 3 years and have had nearly every test and med out there. ; )
posted by bitterkitten at 8:47 AM on December 14, 2011

IANYD but I agree with amro that anxiety can cause a lot of it and that you have to have a thorough checkup. That said, to answer your specific question, a lot of the symptoms that you list can be caused by migraine, although a lot of people just think of it as a bad headache. For years I got the numbness/pressure in the face, weird visual stuff and light-headedness, not knowing what was causing it. It turned out that I was getting migraines although I do not get the headaches that would tip off a doctor. As I got older, I started getting auras, so it was then easy to diagnose. If you take a look at the symptoms, you will see a lot of your troubles listed. Here is a link to symptoms as listed on the website of the Mayo Clinic.
If you are feeling weird, that can trigger panicky feelings, so you can have one condition setting off the other giving you lots of diverse symptoms. Given that you have had panic attacks before, perhaps this is what is going on.

There are migraine triggers and you have to try to figure out what they are for you. The New York Times has some good stuff about migraines in their archives. Keeping a journal can help pinpoint what your triggers are. I use a service (used to be free but moving to a pay-model) www.mediclim.com that gives alerts that I find useful.
Good luck.
posted by PickeringPete at 8:49 AM on December 14, 2011

bitterkitten: I think it did in my case, possibly due to excessive acid production leading to a form of esophagitis (they did find some redness with an upper endoscopy). I'd suspect a small haital hernia could have the same effect...where excessive acid could make its way above the stomach causing a vagal response if irritating. I'm also thinking of excess acid production if the OP is swallowing this mucus (eg. post nasal drip)
posted by samsara at 8:56 AM on December 14, 2011

I used to live with a woman who was working on a clinical trial for Fabry Disease, a relatively rare metabolic disease, so every time someone asks about symptoms including neuropathy, I suggest that they look it up. So I'm suggesting that you look it up.

It is quite rare and it is genetic, but the nice thing is that the clinical trial she was working on in addition to a couple others have shown that enzyme replacement therapy, while expensive, works quite nicely.
posted by sciencegeek at 9:30 AM on December 14, 2011

When I had Guillain-Barre syndrome I had pins & needles in my hands and feet, weakness, & generally felt upset. And it doesn't show up on an MRI. But it got steadily worse over the course of ~2 weeks, instead of getting better, and is also fairly rare, so that's probably not it. But you could always read up on it on the internet to freak yourself out, if you want!
posted by staboo at 9:38 AM on December 14, 2011

I'm going to second testing your B12 -- there is a regular serum blood test, but tell your neurologist to do an MMA (also a blood test) and a urine test too. Just as a rule-out. My neurologist did them. There is also a test for Celiac, and maybe they can add for Pernicious Anemia, which is what I have. PA is an auto-immune disorder that doesn't allow for absorption of B-12. Good luck!
posted by mamabear at 10:01 AM on December 14, 2011

I occasionally have the same issues: numbness, asymmetrical facial tingling, skin that feels sunburned, feeling dizzy, feeling tired, trouble with processing vision. My issues appear mostly in the morning when I've slept too long, or at big social events when there are too many people for the space. Eventually, I took at trip to the hospital and was told that they were migraines and there was not much I could do about them except ride them out.

However, I noticed that my symptoms went away completely while I was pregnant. During my pregnancy my blood pressure went from being deathly low to in the normal range for the first time and I chugged buckets of water. After I gave birth the migraines returned with a vengeance. I discussed the issue with my doctor and a specialist and we concluded that my symptoms come from extremely low blood pressure brought on by dehydration.

So now, when I feel my symptoms returning I drink a few big glasses of water, take two ibuprofen and lay down for a few minutes. Usually, I recover within half an hour.

If you have low blood pressure and are prone to forgetting to eat and drink you might want to bring it up at your next appointment.
posted by Alison at 10:48 AM on December 14, 2011

It sounds like when my wife had a temporary boutof Bells Palsy.
posted by 4ster at 12:27 PM on December 14, 2011

And Bell's Palsy can occur with Lyme Disease.
posted by ellenaim at 4:46 PM on December 14, 2011

Sounds alot like when I get migraines. I got symptoms similar to this, sometimes minus the headache, prior to finding out I had migraines. Scared the hell out of me. Stress or seasonal changes seem to make the symptoms worse in my case.
posted by fan_of_all_things_small at 9:01 PM on December 14, 2011