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What Causes Muscle Spasms On The Left Side Of The Body?
Question: My grandmother (91 years old) is experiencing muscle spasms in her left side of her body (left arm and left leg) This issue arose after a cortisone steroid shot for her shoulder. What might be the causes of this? Before the cortisone shot, she was on cummadin, thyroxine, Prilosec prescription medication. I am very confused as to what medications or events could have caused this. Please help.
Brief Answer:
Possible stroke.
Detailed Answer:
I read your question carefully and I understand your concern.
Since the symptoms involve not only the upper limb but the lower one as well then direct local peripheral nerve damage from the needle is unlikely.
When the symptoms involve one half of the body then the organ which anatomically justifies that is the brain which is responsible for movement control, in this case would be the right side of the brain which covers the left side of the body.
A sudden event such as this makes the diagnoses of stroke more likely. She seems to already be someone at high risk for stroke given her age, thyroid problems and the fact she is taking coumadin (which is used to try and prevent stroke, but not always effective - when dose too low may still have ischemic stroke and if too high hemorrhagic stroke). Other types of brain lesions such as a brain tumor are less likely as usually they have a more slow progressive course, although they may manifest at times suddenly when they cause seizures.
So I would say an evaluation by a neurologist is necessary as well as brain imaging to check for the above mentioned possibilities.
I remain at your disposal for other questions.
Possible stroke.
Detailed Answer:
I read your question carefully and I understand your concern.
Since the symptoms involve not only the upper limb but the lower one as well then direct local peripheral nerve damage from the needle is unlikely.
When the symptoms involve one half of the body then the organ which anatomically justifies that is the brain which is responsible for movement control, in this case would be the right side of the brain which covers the left side of the body.
A sudden event such as this makes the diagnoses of stroke more likely. She seems to already be someone at high risk for stroke given her age, thyroid problems and the fact she is taking coumadin (which is used to try and prevent stroke, but not always effective - when dose too low may still have ischemic stroke and if too high hemorrhagic stroke). Other types of brain lesions such as a brain tumor are less likely as usually they have a more slow progressive course, although they may manifest at times suddenly when they cause seizures.
So I would say an evaluation by a neurologist is necessary as well as brain imaging to check for the above mentioned possibilities.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much Doctor Taka,
It would seem unlikely that she had a stroke because she isn't experiencing the other symptoms currently nor has she in the past to my knowledge. She hasn't had slurred speech or any signs of muscular paralysis in the face or slurred speech. Perhaps there is a smaller degree of strokes that could have happened without much notice? The possibility of her thyroid causing problems remains non the less. She recently had an ablation procedure for her congenstive heart failure, and the perscription for her thyroid medication had to be reduced significantly. The spasms have been occurring in a more frequent manner after the thyroid perscription was reduced. Does this point to a greater possibility that the problem lies within her thyroid functions? If that may be, would hormonal imbalance from the thyroid be a vector for such sudden spasms? Thank you immensely for your help and thorough insight.
It would seem unlikely that she had a stroke because she isn't experiencing the other symptoms currently nor has she in the past to my knowledge. She hasn't had slurred speech or any signs of muscular paralysis in the face or slurred speech. Perhaps there is a smaller degree of strokes that could have happened without much notice? The possibility of her thyroid causing problems remains non the less. She recently had an ablation procedure for her congenstive heart failure, and the perscription for her thyroid medication had to be reduced significantly. The spasms have been occurring in a more frequent manner after the thyroid perscription was reduced. Does this point to a greater possibility that the problem lies within her thyroid functions? If that may be, would hormonal imbalance from the thyroid be a vector for such sudden spasms? Thank you immensely for your help and thorough insight.
Brief Answer:
Read below.
Detailed Answer:
Thank you for the additional information.
Metabolic issues can lead to muscle spasms. Thyroid function changes not typically, but electrolyte abnormalities in particular alterations of calcium, magnesium or potassium levels.
However why I point to the brain is the fact that the symptoms are only on the left side. Metabolic or hormonal alterations in the blood affect the whole body and should cause symptoms on both sides, not only on the left. It is for that reason that I indicated a brain related cause.
As for the fact of the lack of paralysis or speech issues while that is indeed the most typical presentation that doesn't have to necessarily be the case. Stroke means damage of a brain are either due to the lack of blood supply in that area (ischemic stroke) or a bleed in that area (hemorrhagic stroke). The symptoms depend on the area involved, different brain areas have different functions. A stroke, say in the basal ganglia, a part involved in movement control (not strength) may manifest with abnormal movements like involuntary muscle contractions. Another scenario might also be that what you call a muscle cramp might actually be a focal seizure.
So while naturally some routine blood tests for metabolic changes will have to be done alongside brain imaging, I still would put a brain lesion as the first possibility to be considered as long as we have symptoms only on the left.
Let me know if I can further assist you.
Read below.
Detailed Answer:
Thank you for the additional information.
Metabolic issues can lead to muscle spasms. Thyroid function changes not typically, but electrolyte abnormalities in particular alterations of calcium, magnesium or potassium levels.
However why I point to the brain is the fact that the symptoms are only on the left side. Metabolic or hormonal alterations in the blood affect the whole body and should cause symptoms on both sides, not only on the left. It is for that reason that I indicated a brain related cause.
As for the fact of the lack of paralysis or speech issues while that is indeed the most typical presentation that doesn't have to necessarily be the case. Stroke means damage of a brain are either due to the lack of blood supply in that area (ischemic stroke) or a bleed in that area (hemorrhagic stroke). The symptoms depend on the area involved, different brain areas have different functions. A stroke, say in the basal ganglia, a part involved in movement control (not strength) may manifest with abnormal movements like involuntary muscle contractions. Another scenario might also be that what you call a muscle cramp might actually be a focal seizure.
So while naturally some routine blood tests for metabolic changes will have to be done alongside brain imaging, I still would put a brain lesion as the first possibility to be considered as long as we have symptoms only on the left.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Good evening Dr.Taka,
I want to start my question out by conveying my gratitude for the help you have given me as it goes above and beyond the service I expected. I sincerely hope that your hard work and dedication allows for even more rewarding outcomes of your goals and dreams.
Presently, I am eager to confer as much knowledge to my family and grandmother that can possibly be gathered from ,foremostly, you and a few other sources. The situation has not yet improved with regards to my grandmothers physical state, instead I have been given word that her left appendages are suffering from increasingly uncontrollable and instense contractions. She was once able to control or at least quell the onset and frequency of these spasms. Given that her condition is worsening, It seems more likely that a lesion is behind this. With the combination of your help and my meer gut feelings, we have decided it is imperative to get a MRI session Lined up. It is now a most definite problem in her cerebral cortex. Is there a need to push this to an emergency? What area of the XXXXXXX could be the regional source of the spastic neurological firing?( you mentioned the basal ganglia) and finally with equal importance, what could I possibly do to allow her more comfort ,if you may know?
Best regards -XXXXX
I want to start my question out by conveying my gratitude for the help you have given me as it goes above and beyond the service I expected. I sincerely hope that your hard work and dedication allows for even more rewarding outcomes of your goals and dreams.
Presently, I am eager to confer as much knowledge to my family and grandmother that can possibly be gathered from ,foremostly, you and a few other sources. The situation has not yet improved with regards to my grandmothers physical state, instead I have been given word that her left appendages are suffering from increasingly uncontrollable and instense contractions. She was once able to control or at least quell the onset and frequency of these spasms. Given that her condition is worsening, It seems more likely that a lesion is behind this. With the combination of your help and my meer gut feelings, we have decided it is imperative to get a MRI session Lined up. It is now a most definite problem in her cerebral cortex. Is there a need to push this to an emergency? What area of the XXXXXXX could be the regional source of the spastic neurological firing?( you mentioned the basal ganglia) and finally with equal importance, what could I possibly do to allow her more comfort ,if you may know?
Best regards -XXXXX
Brief Answer:
Read below.
Detailed Answer:
Thank you for your kind words. Sorry for answering a little late but due to time differences the question arrived when I had just gone to sleep.
The abdominal spasms seem to be what has convinced you about a brain lesion, but actually for me they make things less certain now. They are not typical and they make necessary blood tests, in particular electrolytes.
Regarding the brain area to be considered that depends on what those spasms constitute, because spasm is a relative term, the people may use the same term for different phenomena. If it is a maintained muscle contraction like dystonia then it is usually related to basal ganglia lesions. If what is meant by spasms are clonic contractures like in seizures then the lesion is near the brain surface triggering seizures. If it is simply increased tonus due to spasticity then it could be anywhere along the traveling fibers route, can’t be said without at least examining the patient.
As for the emergency level, MRIs are not always accessible on an emergent basis, depends also on where one lives. What can be done on an emergency basis is a head CT which evidences most lesions (though not as accurate as MRI) and a blood panel. These can be done in almost all hospital emergency rooms. Afterwards whether MRI is to be scheduled later can be planned according to the tests results.
Read below.
Detailed Answer:
Thank you for your kind words. Sorry for answering a little late but due to time differences the question arrived when I had just gone to sleep.
The abdominal spasms seem to be what has convinced you about a brain lesion, but actually for me they make things less certain now. They are not typical and they make necessary blood tests, in particular electrolytes.
Regarding the brain area to be considered that depends on what those spasms constitute, because spasm is a relative term, the people may use the same term for different phenomena. If it is a maintained muscle contraction like dystonia then it is usually related to basal ganglia lesions. If what is meant by spasms are clonic contractures like in seizures then the lesion is near the brain surface triggering seizures. If it is simply increased tonus due to spasticity then it could be anywhere along the traveling fibers route, can’t be said without at least examining the patient.
As for the emergency level, MRIs are not always accessible on an emergent basis, depends also on where one lives. What can be done on an emergency basis is a head CT which evidences most lesions (though not as accurate as MRI) and a blood panel. These can be done in almost all hospital emergency rooms. Afterwards whether MRI is to be scheduled later can be planned according to the tests results.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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