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Neurology (Expert Forum)
hand weakness
Answered by
CCFNeuroMD JT, MD - Neurology/Epilepsy, Neurology/General
Cleveland - OH
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
hand weakness
by gozosa, Feb 22, 2008 08:36AM
i am a 27 year old female and yesterday i woke up and i couldn't use either of my hands. they didn't tingle, like i had slept on them, but i didn't have the hand strength to push the button on my alarm, open my eyeglass case, squeeze out the toothpaste, turn knobs on door or faucet, etc. it lasted for about 45 minutes and my hands are still much weaker than usual. when i was 16 when i had a car accident and i went to the chiropractor for 4 months after that. i remember he had a hand grip to test strength and i was always really bad before my adjustment. i still have problems making a strong fist, but never to the point where i couldn't function doing everyday things. i'm hoping it is just a pinched nerve, but i had a migraine a couple weeks ago that lasted 2 days that went from my eyeball to the back of my neck on one side. then a few days later another one on the other side for about half a day. i'm not sure if the 2 are related, but i'm worried...
Doctor's Answer
by CCFNeuroMD JT, MD, Feb 22, 2008 02:50PM
, Feb 22, 2008 02:50PM
To: Gozosa
Dear Gozosa,
Thank you very much for your question. I am happy to address the issues that you pose, although it is important that you recognize that my impression is based entirely on the information you have provided in your posting and is by no means a replacement for an office visit with a neurologist. Diagnosis is contingent on detailed history and physical exam and as such, the following information should be considered solely for educational purposes.
To summarize, you are a 27 year old female with recent history of migraine and acute onset of bilateral hand weakness and decreased manual dexterity with incomplete recovery and persistent deficits. You also have a remote history of a motor vehicle accident. Given the bilateral and relative symmetry of your symptoms, if this is truly a neurologic problem going on, it sounds like the lesion would most likely be at the level of the spinal cord. Because you are 27 and female, the first diagnosis that comes to mind would be some sort of a demyelinating process such as Multiple sclerosis or transverse myelitis. What doesn't quite fit with these diagnoses is the fact that your symptoms improved so quickly. The fact that you have a history of eye pain associated with headahce may suggest optic neuritis which basically is a demyelinating process affecting the optic nerve. Optic neuritis is one of the most common presentations for MS. In particular, optic neuritis and spinal cord lesions may be representative of a particular MS variant known as neuromyelitis optico or DeVic's disease.
Other possibilities include a slight downward displacement of the cerebellum known as a Chiari malformation or some sort of migraine variant (less likely).
My recommendations to you at this point would be to see a neurologist who can take a thorough history and conduct a good neurologic exam. After a preliminary evaluation, he or she may opt to check an MRI of the brain and cervical spinal cord to evaluate for brain lesions suggestive of MS. Other tests that may be helpful include a lumbar puncture to evaluate the spinal fluid for evidence of a demyelinating disease as well as visual evoked potentials which can detect lesions present in the optic nerves.
I hope I have not alarmed you with the above- although your symptoms may in fact be nothing at all, your description, to me, is suspicious for MS and I advise you get further evaluated. If you are local in the Cleveland area, you might consider making an appointment in our renown MS clinic called the Mellen Center. Otherwise, MS is a diagnosis that most general neurologists are able to diagnose and treat.
I wish you the best of luck, and thanks for your question.
Best,
JBT, MD
Thank you very much for your question. I am happy to address the issues that you pose, although it is important that you recognize that my impression is based entirely on the information you have provided in your posting and is by no means a replacement for an office visit with a neurologist. Diagnosis is contingent on detailed history and physical exam and as such, the following information should be considered solely for educational purposes.
To summarize, you are a 27 year old female with recent history of migraine and acute onset of bilateral hand weakness and decreased manual dexterity with incomplete recovery and persistent deficits. You also have a remote history of a motor vehicle accident. Given the bilateral and relative symmetry of your symptoms, if this is truly a neurologic problem going on, it sounds like the lesion would most likely be at the level of the spinal cord. Because you are 27 and female, the first diagnosis that comes to mind would be some sort of a demyelinating process such as Multiple sclerosis or transverse myelitis. What doesn't quite fit with these diagnoses is the fact that your symptoms improved so quickly. The fact that you have a history of eye pain associated with headahce may suggest optic neuritis which basically is a demyelinating process affecting the optic nerve. Optic neuritis is one of the most common presentations for MS. In particular, optic neuritis and spinal cord lesions may be representative of a particular MS variant known as neuromyelitis optico or DeVic's disease.
Other possibilities include a slight downward displacement of the cerebellum known as a Chiari malformation or some sort of migraine variant (less likely).
My recommendations to you at this point would be to see a neurologist who can take a thorough history and conduct a good neurologic exam. After a preliminary evaluation, he or she may opt to check an MRI of the brain and cervical spinal cord to evaluate for brain lesions suggestive of MS. Other tests that may be helpful include a lumbar puncture to evaluate the spinal fluid for evidence of a demyelinating disease as well as visual evoked potentials which can detect lesions present in the optic nerves.
I hope I have not alarmed you with the above- although your symptoms may in fact be nothing at all, your description, to me, is suspicious for MS and I advise you get further evaluated. If you are local in the Cleveland area, you might consider making an appointment in our renown MS clinic called the Mellen Center. Otherwise, MS is a diagnosis that most general neurologists are able to diagnose and treat.
I wish you the best of luck, and thanks for your question.
Best,
JBT, MD
A neurologic examination can give important information about the origin of your symptoms
Since you were probably in a lot of pain and perhaps walking differently, it is possible you tweaked a nerve in the leg or foot and this caused the minor muscle spasm.
You might want to get a blood test for Vit. B levels, thyroid etc., and if it happens again, the headache I mean, try to get into your doctor's office and have him check for the Occipital pain.