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What Does Pain In Arm, Followed By Transient Disorientation And Involuntary Jerky Movements Indicate?

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Posted on Tue, 1 Apr 2014
Question: Hi. 3 days ago I wok up in the night with pain to the right hand shoulder. Then 2 days later I had a quiet and enjoyable day, but on my way when I was going to buy coffee I had a pain in my wrist for a while which I applied pressure to. Then I was disoreinted for a very short period maybe up to two minutes Then someone in the street asked me if I was okay which I said 'yes' when I wasnt. Then when I got into shop to buy coffee I felt a strange sensation in the head which is hard to describe. Then I was worried for about two minutes if I need ambulance for someone asking me in the street if Im alright. Then on the way home coming up my street my arm stared to do something very strange it felt like it was kind of out of socket like kind of hanging and immobilised and I became distressed for about 5 minutes. Then when I got out the front of my home I called for ambulance 'cos this never happened to me before. No heavy lifting on the day. Then outside my home my arm started moving out to the side involuntarily and, my arm became like somebody elses arm, not my own, when my fingers looked kind of swelled up and my arm jutting out to the side and lifting I couldnt recognise my arm, when it started lifting and moving, without my accord, and it reminded me of a disabled man's arm I have seen before, not like my own, and it took on a different appearance consistent with this. It was not like my arm I have had for 40 years, and it has never behaved this way before either. And I lost sensation in the arm and there was tingling like pins and needles and it became numb later sore. But I had these involuntary movements of my arm that I wasnt doing, just moving by itself and I became very worried. Later on the affected hand was colder to the touch than the other and I had 2 sessions where my arm was moving on its own, at its own accord< I wasnt controlling it. at 5:40 I left the hospital without seeing the Doctor as I was tired and the symptoms had subsided by then so I went home for some rest. Next day, today my arm was still sore, and after resting today my arm was still feeling immobilised when I went out so I applied a bandage and it is starting to feel better and now feeling is starting to return.
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Answered by Dr. Rakesh Karanwal (2 hours later)
Brief Answer: MRI Brain and EEG tests required at the earliest Detailed Answer: Hi Ms. XXXX, Thanks for your query. Rapidly progressive symptoms, starting with pain in arm, followed by transient disorientation and subsequently, involuntary jerky movements, suggest two possibilities :- * Right Partial seizure with transient paralysis. This may due to either, scarring of the LEFT-SIDED brain following old head injury, a lesion, tumor or a granuloma; or, a Transient Ischemic Attack (reversible Stroke). The first cause is more likely. * The diagnosis will be confirmed by MRI Brain and EEG (Electroencephalogram). Consult your doctor and apprise him of my opinion. I am certain that he will agree with me; order advised tests, and- based on the reports- will arrive at a certain diagnosis and prescribe suitable treatment as advised. Hope I have addressed your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards, Col (Dr.) Rakesh Karanwal
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Rakesh Karanwal (54 minutes later)
Does this mean I was having a stroke. I wasnt sure if I was having a stroke. Thats why I called an ambulance as well. I have heard that this is treatable if caught early on but after more than 6 hours of waiting for ambulance and hospital I was hungry and tired and I thought maybe I had just pulled a nerve. As when sleeing other night and waking up in pain my shoulder felt like it was out for a moment before this strange sensation passed that I hadnt felt before. Then pain stopped after minute or two, if something was out it went back into place, then pain stopped so I went back to sleep. When ambulance took more than hour to come, I felt like I was going to die, just before they arrived, (I was just like ...if this is it...)It got worse and felt like I could not get off the chair to answer the door by the time they got there. at 4:40am this morning I left the hospital, lady said I was next but she didnt know how long it would be then someone went in before me. So, lie and as there were no longer visible symptoms before Dr came out anyway I didnt thinK I would be admitted, he will say, "your fine" and make me feel like an idiot for calling an ambulance. Thats what the Dr said there, last time I was at the emergency there when I had been feeling dizzy and I thought the symptoms could be explained with pulling a nerve in my sleep the other night hence the tingling and numbness. I was really worried at time it was happening and very distressed at not knowing what was going on. I wasnt sure if I was having a stroke and I thought that I should be medically assessed. Not being able to wait until 6:00am until I can see I Dr I decided I was better off to Go home and get some sleep and call somebody who Care's. I have been wondering what happened. Some initial relief with Bandage, but arm is still sore. Thankyou, for listening Much Love
doctor
Answered by Dr. Rakesh Karanwal (7 hours later)
Brief Answer: It was most likely a type of Focal Seizure of arm Detailed Answer: Just relax, XXXXX! Like I said earlier, it was most likely a partial seizure (earlier called Focal seizure) involving the right arm and associated disorientation without loss of consciousness. It is remotely possible that- during the brief seizure in the form of bizarre involuntary movements of the arm- there may have been a momentary dislocation of the shoulder joint, which got restored following a certain movement of the arm. The persisting soreness of the arm is perhaps due to either, spasm of the arm muscles or, mild transient compression of the nerves by the dislocated shoulder. Further, I had simply said that a temporary stroke- which occurs due to momentary disruption of blood supply to the brain- was the other- though less likely- possibility. And Yes! I fully agree with you that preventive remedial measures prevent permanent stroke (if at all, it was a transient reversible stroke). You should not wait for another episode, but take an appointment with a Neurologist at the earliest, explain the sequence of events in detail and apprise him of my opinion. I am sure he will give you a patient hearing, examine you thoroughly and ask for MRI brain and EEG. Do not lose heart: BE BRAVE and maintain your cool. Everything is going to be all right. Just meet the neurologist and have faith in him. I wish you all the best, XXXX. I shall always be available as and when you need my advice. You can bank on me. God Bless You Dr. Rakesh Karanwal
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Rakesh Karanwal

Internal Medicine Specialist

Practicing since :1980

Answered : 1357 Questions

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What Does Pain In Arm, Followed By Transient Disorientation And Involuntary Jerky Movements Indicate?

Brief Answer: MRI Brain and EEG tests required at the earliest Detailed Answer: Hi Ms. XXXX, Thanks for your query. Rapidly progressive symptoms, starting with pain in arm, followed by transient disorientation and subsequently, involuntary jerky movements, suggest two possibilities :- * Right Partial seizure with transient paralysis. This may due to either, scarring of the LEFT-SIDED brain following old head injury, a lesion, tumor or a granuloma; or, a Transient Ischemic Attack (reversible Stroke). The first cause is more likely. * The diagnosis will be confirmed by MRI Brain and EEG (Electroencephalogram). Consult your doctor and apprise him of my opinion. I am certain that he will agree with me; order advised tests, and- based on the reports- will arrive at a certain diagnosis and prescribe suitable treatment as advised. Hope I have addressed your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards, Col (Dr.) Rakesh Karanwal