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Having intermittent hand numbness. Took topamax. Get palpitations. Wgat can be done?

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General & Family Physician
Practicing since : 2009
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I have been having intermittent hand numbness. Comes on without warning. Discussed with my primary and we thought it may be a side effect of a medication (topamax) which I take for migraines. However, on a whim today I took my pulse when it happened and it was 48. It lasted for about 20 minutes and then it went back to its usual 70-80. I do get palpitations occasionally. Have noticed the nummbness while working out but never took my pulse until today. Have had a negative stress echo due to c/o sob with stairs. Felt it shouldnt be with the amount of exercise I get. Symptoms did not occur with Holter monitor. Very frustrating.
Posted Sun, 4 Aug 2013 in General Health
Answered by Dr. Luchuo Engelbert Bain 1 hour later
Hi and thanks for the query,

A pulse at 48 , I am afraid deserves a careful evaluation. Fluctuations of the pulse, coupled with this clinical syndrome of numbness must be carefully evaluated. It s almost conclusive there should a rhythm problem with the heart which should be identified and treated on time. A cardiac ultrasound and a repeat Electrocardiographic analysis, coupled by a clinical evaluation by your cardiologist is compelling. Nodal tissue malfunction (Pacemaker, Artrioventricular Node and His) malfunction could generally present as such. Other cardiomyopathies could also present as such.

I strongly suggest you book an appointment with your cardiologist. Your family physician could ask for the electrocardiogramme and Cardiac ultrasound while waiting as you arrange to see the cardiologist.

Thanks and hope this helps. Kind regards as I wish you good health.

Bain LE, MD.

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