Pins and needles feeling in right hand, stiffness in hand, tongue and lips feel numb, nausea, headache, lack of focus
Thank you for writing in.
I am a medical specialist with an additional degree in Cardiology.
I am afraid details given by you are insufficient for me to be of any significant help.
Kindly describe your headaches and other sensations in as much details as possible. Like can you anticipate an episode is going to occur? Is the symptoms complex always the same or different? Do you actually vomit during episode too? How long each episode lasts? What drugs you are taking a) to prevent b) to cut short an episode and so on.
I will get back as soon as I get a followup question. If you have any investigations you want to upload you can do so.
Looking forward to your second email.
Dr Anil Grover
MBBS, MD(Medicine) DM(Cardiology)
I take no drugs not have I seen anyone before. I am phsically fit my blood pressure isnt particulary consistient it fluctuates between ave to low. Im 6 foot 4 with a bmi of 24-25. My only illness previously is idiopathic AIHA when I was 35 hb dropped to 3 but now is steady at between 13-16m I also snapped the nerve in my ankle 2 years ago and have 60% sensation back in my foot.
Thanks a lot for writing back. It helps a lot in analyzing your problem and suggest a solution. Undoubtedly, you are having are infrequent episodes of Migraine. In your own words frequency is not much therefore it means, simpler home remedies can be tried, hopefully they will help. About what triggers you mentioned- while you at computer or you are driving. Well working with computer involves sensory visual stimuli and driving involves, no matter how good driver you are, concentrating (at least for your own safety on other driver’s mistakes). Both activities are stressful at least at subconscious level. As both can not be avoided, one has to live with these.
Migraine-not necessary every phase in everyone-passes through 4 phases
1. Prodrome: One or two days before a migraine you may (or may not: that is operative word) have any one or more of the following: Constipation, Depression, Diarrhea, Food Cravings, hyperactivity, irritability or neck stiffness. You have reported none that is possible.
2. Aura: Most do not have it but you have pins and needle sensation. Other phenomenon are described are visual phenomenon, speech or language problems from slurring to aphasia.
3. Attack: Typically described duration is 4-72 hours in your case fortunately it is less. One may have pain on one side of head, usually throbbing pulsating, sensitive to light & sound, and as in your case nausea which abates in some can results in vomiting. One may faint or just feel sleepy. You do the later.
4. Postdrome, occurs after migraine which occurs in you too. One feels drained unable to do concentrate do fine wok with dexterity (as you described)
Now we come to question when to see the doctor: Two situations: when one is having suspicion of almost similar but serious illness. Examples are: fever with headache and vomiting, an abrupt severe headache like a thunderclap, rash, stiff neck, mental confusion, seizures, weakness associated with usual symptoms attributable to migraine. Second situation is when home remedies which are listed as follows fail to provide relief and then XXXXXXX the doctor and discuss about medical treatment:
1. Muscle Relaxation exercises, including Yoga, listening to music or what you
find soothing like gardening, taking a hot bath or reading.
2. Get enough sleep (6-7 hours) but do not oversleep, wake up at regular
3. Rest and Relax, say in between working on computer
4. Keep a headache diary even after you have seen a doctor.
Seeing the Doctor:
As not much is known about pathology except that there is imbalance of brain chemicals : fall in serotonin levels and release of neuropeptidases which cause sensory irritation causing various symptoms including headache.
Discuss with doctor the treatment plan depending upon frequency and severity of attack. There is huge list of medications which has been found useful to name a few: Pain relievers like Tylenol to indomethacin; Triptans(almotriptan, naratriptan, zolmitriptan) ergot preparations (Cafergot, Migergot, Dihydroergotamine); anti nausea medications, opiates like codeine and dexamethasone. All are prescription medications and therapy is individualized.
I hope this write up shall be of use to you. I could sense a tinge of ruefulness when you wrote that you are 6’4” with BMI <25, yes fit people can have little chemical problems with their nervous system.
If you have any question, I will be pleased to answer. If none; please close the query with comments. Thank you.
With Best Wishes
Dr Anil Grover
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