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Tingling in arms, hands become blue and black. Low BP, nausea and dizziness. Not getting oxygen to brain?

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Hi, am 41 years old and for the last few years have had problems during the night where I have woke up with tingling in my arms, was referred to a neurologist who found nothing wrong but due to nocturnal episodes referred me to a chest specialist to look at sleep apnoea, since then the nocturnal episodes have increased, the tingling in my arms has increased, my hands go blue/black and when I stand up my blood pressure can be as low as 82/63. I am becoming increasingly dizzy especially when moving about and suffer from chest pain and feel like I'm going to faint, also suffer from nausea and am sometimes sick, feels like I'm not getting enough oxygen to my brain, as I get confused and dizzy. One doctor said it could be brain ischema, please help.
Posted Tue, 22 May 2012 in Sleep Disorders
Answered by Dr. Sumit Bhatti 2 hours later

Thank you for your query.

1. Since your hands go blue/black, get a Neck Vessel Color Doppler study done along with an MRI of the brain, CT of the Sinuses and an MR Angiography. Get chest and neck X-rays and a 2D Echo of the heart done.

2. Have you undergone a sleep study? That would pick up a sleep breathing disorder. What is your BMI (Body Mass Index)?

3. Get a physician's or neurologist's opinion by a tilt table test or blood pressure reading to rule out orthostatic or postural hypotension. A thoracic outlet syndrome, cervical spondylosis and cervical ribs should be ruled out. Rarer conditions such as an Vertebrobasillar insufficiency XXXXXXX Chiari malformation, CSF (Cerebro-Spinal Fluid) leaks and so on.

4. Blood investigations to rule out hyperviscocity, homocyteine levels, hypothyroidism and calcium deficiency are recommended. Do you have exposure to alcohol or smoking?

5. Such severe signs and symptoms are usually not seen in allergy and gastric reflux. These may be treated separately.

6. Kindly let me know the results of your tests. This will help in suggesting further treatment.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

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