Brief Answer:
Right hand symptoms

Detailed Answer:
Good morning. My name is Dr. Saghafi and I am a neurologist in XXXXXXX OH, USA. I would like to give you some ideas about your symptoms and hopefully, this will help direct you to proper medical attention where you're at....unless you'd care to cross the "puddle" (as I saw it listed on the map! LOL....followed by "the pond" to land up here at my doorstep?? HA!

At any rate young lady...here I have your symptoms as pins and needles as well as numbness in the right hand. In addition, you are complaining of some odd symptoms of dizziness upon lying down or moving about and some bodily twitches during day as well as evening/nighttime hours. Some days you are perfectly fine? Does that mean no symptoms in the hand either?

Duration of this constellation of symptoms is 18 months on a more episodic or intermittent basis but over the past 2 months they've come on with more intensity and frequency.

Does that just about sum it up?

Well, although I could ask many many questions to try and nail down additional information let's just focus on what you've said and how that should be approached. I believe that for your age and gender these symptoms could represent several things:

1. Nutritional deficiencies (B12, folate, Vit. D, Magnesium, Calcium).

2. Endocrine problems such as thyroid malfunction, adrenal malfunction, parathyroid malfunction, liver, or kidney malfunction

3. You may have at least 2 different problems involving the right wrist such as what could possibly be a carpal tunnel type of picture vs. a more systemic problem involving the brain and spinal cord. Things that come to mind could include demyelinating types of problems, collagen vascular types of problems

4. Stress and anxiety which could be operating alone or in concert with any of the above.

Therefore, in my estimation and how I would approach a patient such as yourself to get to the bottom of what could be causing these symptoms would be to perform a very thorough history and physical examination as to when and how the symptoms you mention started and evolved and then, launch into some laboratory tests to address the metabolic concerns above of certain nutritional elements, electrolytes, etc.

I would see what those results were and then, depending upon my examination results decide on the necessity of performing diagnostic studies such as MRI of the brain/spinal cord, EMG (electrical studies of the right hand and other muscles of the body involved in twitching, etc.).

I would also throw in a neuropsychological battery of tests IF NONE OF MY OTHER TESTING revealed anything specific or definite that I could easily treat with lifestyle changes or medication.


I'd appreciate the favor of your providing a STAR RATING and some brief written feedback if your question has been satisfactorily answered. In addition, CLOSING THE QUERY on your end will also be most helpful.

Don't forget that my webpage to keep me abreast as to how you're doing is:

bit.ly/drdariushsaghafi

All the Best

This query has required a total of 35 minutes of physician specific time to read, research, with envoy synthesis.

---