Brief Answer:
Differential diagnosis of tingling and approach

Detailed Answer:
Hi XXXXXXX welcome to HCM.


I can understand your concern about your mother. She is having tingling sensations in right hand, which is a positive sensory symptom. First I will brief you about her differential diagnosis and then tell you about; how to approach. Tingling sensations can be due to

- Cervical spondylosis especially compression of C7-T1 nerve roots (main nerve roots which form hand nerves). Nerve root compression at right neural foramina can result in tingling sensations, neck pain radiating to right hand, sometimes weakness on hand.

- Neuropathy - Neuropathy of median and ulnar nerve (nerves which supply hand), right hand can cause such symptoms. It could be due to diabetes, vitamin B12 deficiency, age related, ischemic damage, thoracic outlet syndrome.

- Carpal tunnel syndrome - Median nerve (a hand nerve) can get compressed in wrist and result into severe tingling sensations in hand. It can be compressed due to weak bone (osteoporosis), post-menopause (hormonal imbalance), work related.

- Ischemia of right hand as a result of narrowing of radial or ulnar artery. It can be due to atherosclerosis or arteriosclerosis. It is uncommon. So I am keeping it as last possibility.

- Insignificant symptom. It can be suspected if everything is normal. It means tingling happened temporarily without any underlying cause. It is called "idiopathic".

Now you are aware of differential diagnosis. To confirm, you have to show her to neurologist. He/she will examine her neurological system and take detailed history. After it, few investigations will be needed to confirm diagnosis and cause

- Nerve conduction velocity of median, ulnar and radial nerve

- MRI cervical spine to know about cervical disc, cervical spondylolisthesis.

- If doubt about carpal tunnel syndrome, MRI of wrist with FIESTA image.

- Blood sugar level, vitamin B12 level.

All investigations are not needed at same time. Depending upon the history and examination findings, the investigations will be decided. Further treatment will depend upon the diagnosis.

Hope it will her. If you have any doubt, do let me know. At home, you can give her tablet Pregabaline for temporary relief, after prescription. Usual adult dose is 75mg twice a day (what I prescribe).

Thanks. Take care.

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Brief Answer:
thank you for the appreciation

Detailed Answer:
Hi XXXXXXX welcome back.

Thanks a lot for the appreciation. If you need any help, do let me know.

Thanks. Best wishes for your mother.

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