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Right Arm/Hand shakes and goes numb
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Right Arm/Hand shakes and goes numb

I'm a 46 woman who has always worked hard her whole life such as doing janitorial jobs. I have recently had my right arm/hand go numb various times during the day and night and for the past week my arm/hand has started to randomly shake vigouriously for about 3 minutes than the shaking would diminish and finally stop. What could this be and if it helps the only medical issue I have is that I'm anemic.
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Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Numbness in the hands and fingers has a large differential. It really depends on the location of the sensory changes. If they occur more on the lateral fingers, it may be carpal tunnel syndrome. If the numbness occurs on the medial fingers (pinky and half of the ring finger) and medial aspect of palm, it may be a neuropathy from the ulnar nerve. This nerve is also known as your “funny bone” when tapped or hit. It has several sites of compression along its course – one site being at the elbow. Classically, it may be a truck driver who rests elbow on window/door. It should also be mentioned that with rapid weight gain or weight loss, the ulnar nerve or median nerve (which causes carpal tunnel syndrome) can be compressed and cause their neuropathies.  

These neuropathies can be caused by many mechanisms including microtrauma (overuse such as repetitive motions on the job), hypothyroidism, weight changes, amyloidsosis, and diabetes, to name a few.

I recommend that you follow up with your local neurologist. He/she will perform a specific neurological examination focused on the ulnar and median  nerves. The neurologist may also elect to perform an EMG/NCS to evaluate the motor and sensory components of the median and ulnar nerves as they travel to the wrist. Other labs, such as vitamins and autoimmune panels, and neuroimaging, such as MRI, may be ordered based on the history that the neurologist may obtain.

Treatment options for the ulnar and median neuropathies (if diagnosed) include surgical release/correction. However, less invasive procedure such as splinting should be tried first. Medications are usually directed at the underlying cause and include NSAIDs such as ibuprofen. However, if the neurologist, after examining you and obtaining an adequate history, neuropathic pain may be diagnosed. The treatment for this includes medications such as neurontin and lyrica and elavil (which is an antidepressant but has actually been found to be helpful with neuropathic pain as well).

But you also mention shaking of the hand. Is this voluntarily or involuntarily? If involuntarily, I would be concerned of a focal seizure. This can be diagnosed with an EEG, and if diagnosed, can be treated medically. If involuntarily and occurs with standing or upright posture, limb shaking TIA should be considered. This would be best evaluated with an MRI of the brain and MRA of the vasculature with/without a carotid US of the neck.

I highly suggest you follow up with a neurologist in your area. Your symptoms are concerning especially without knowing more information.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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