Transient Paresthesias of the hands, feet, legs, and arms are common transient symptoms. The briefest electric shock type of paresthesia can be caused by an impact on the comparatively unprotected
ulnar nerve near the elbow; this phenomenon is colloquially known as bumping one's "funny bone". Other common examples occur when sustained pressure has been applied over a
nerve, inhibiting or stimulating its function. Removing the pressure typically results in gradual relief of these paresthesias. Similar brief shocks can be experienced when any other nerve is injured (e.g., a pinched neck nerve may cause a brief shock-like paresthesia toward the scalp). Spinal column irregularities may injure the spinal cord briefly when the head or back is turned, flexed, or extended into brief uncommon positions (
Lhermitte's sign). The most common everyday cause is temporary restriction of nerve impulses to an area of nerves, commonly caused by leaning or resting on parts of the body such as the legs (often followed by a pins and needles tingling sensation).
Reactive hyperaemia, which occurs when blood flow is restored after a period of
ischemia, may be accompanied by paresthesia too, e.g., when patients with
Raynaud's disease rewarm after a cold episode. Other causes include conditions such as
hyperventilation syndrome and
panic attacks, in which paresthesias of the mouth, hands, and feet are common, transient symptoms. A cold sore outside the mouth (not a
canker sore inside the mouth) can be preceded by tingling due to activity of the causative
herpes simplex virus. The
varicella zoster virus, which causes
shingles, also notably may cause recurring pain and tingling in skin or tissue along the distribution path of that nerve (most commonly in the skin, along a
dermatome pattern, but sometimes feeling like a headache, chest or abdominal pain, or pelvic pain). Paresthesias can also be a symptom of
mercury poisoning.
Seafood poisoning is also possible, e.g.,
ciguatera toxin is produced within
dinoflagellate plankton, which when consumed by other sea animals and then by humans, can lead to perioral paresthesia and temperature-related
dysesthesia. Cases of paresthesia have also been reported at varying frequencies following
anthrax,
flu,
HPV, and
COVID-19 vaccine intake.
Benzodiazepine withdrawal may also cause paresthesia, as the drug removal leaves the
GABA receptors desensitized. Benzodiazepines (e.g.,
Xanax and
Valium) can be prescribed to try to relax
muscle spasms or suppress
epileptic seizures.
Chronic Chronic paresthesia (Berger's paresthesia, Sinagesia, or
meralgia paresthetica) indicates either a problem with the functioning of neurons, or poor
circulation. In the elderly, paresthesia is often the result of poor circulation in the limbs (such as in
peripheral vascular disease), most often caused by
atherosclerosis, the build-up of plaque within artery walls over decades, with eventual
plaque ruptures, internal clots over the ruptures, and subsequent clot healing, but leaving behind
narrowing or closure of the artery openings, locally and/or in downstream smaller branches. Without a proper supply of blood and nutrients, nerve cells can no longer adequately send signals to the brain. Because of this, paresthesia can also be a symptom of
vitamin deficiency or other malnutrition, as well as metabolic disorders like
diabetes,
hypothyroidism, or
hypoparathyroidism. Irritation to the nerve can also come from inflammation to the tissue. Joint conditions such as
rheumatoid arthritis,
psoriatic arthritis, and
carpal tunnel syndrome are common sources of paresthesia. Nerves below the head may be compressed where chronic neck and spine problems exist, and can be caused by, among other things, muscle cramps that may be a result of clinical anxiety or excessive mental stress,
bone disease, poor posture, unsafe heavy lifting practices, or physical trauma such as
whiplash. Chronic paresthesia can sometimes be symptomatic of serious conditions, such as a
transient ischemic attack; or
autoimmune diseases such as
multiple sclerosis,
complex regional pain syndrome, or
lupus erythematosus. The use of
fluoroquinolones can also cause paresthesia.
Brainstem stroke survivors and those with
traumatic brain injury (TBI) may experience paresthesia from damage to the central nervous system.
Acroparesthesia Acroparesthesia is severe pain in the extremities, and may be caused by
Fabry disease, a type of
sphingolipidosis. It can also be a sign of
hypocalcemia.
Dentistry Dental paresthesia is loss of sensation caused by maxillary or mandibular anesthetic administration before dental treatment. Potential causes include trauma introduced to the nerve sheath during administration of the injection, hemorrhage about the sheath, more side-effect-prone types of anesthetic being used, or administration of anesthetic contaminated with alcohol or sterilizing solutions.
Drugs •
Anticonvulsant pharmaceutical drugs, such as
topiramate,
sultiame, or
acetazolamide •
Antidepressant discontinuation syndrome •
Benzodiazepine withdrawal syndrome •
Beta alanine •
Dextromethorphan (recreational use) • Intravenous administering of strong
pharmaceutical drugs acting on the
central nervous system (CNS), mainly
opiates,
opioids, or other
narcotics, especially in non-medical use (
drug abuse) •
Ketorolac •
Lidocaine poisoning •
Lomotil •
Nitrous oxide, long-term exposure •
Ritonavir Other Other causes may include: •
Autonomous sensory meridian response ("ASMR") •
Carpal tunnel syndrome •
Cerebral amyloid angiopathy •
Chiari malformation •
Coeliac disease •
Complex regional pain syndrome •
Cubital tunnel syndrome •
Decompression sickness •
Dehydration •
Erythromelalgia •
Fabry disease •
Fibromyalgia •
Fluoroquinolone toxicity •
Guillain–Barré syndrome (GBS) •
Heavy metals •
Herpes zoster •
Hydroxy alpha sanshool, a component of
Sichuan peppers •
Hyperglycemia (high
blood sugar) •
Hyperkalemia •
Hyperventilation •
Hypocalcemia, and in turn: •
Hypermagnesemia, a condition in which hypocalcemia itself is typically observed as a secondary symptom •
Hypoglycemia (low
blood sugar) •
Hypothyroidism •
Immunodeficiency, such as
chronic inflammatory demyelinating polyneuropathy (CIDP) •
Lupus erythematosus •
Lyme disease •
Magnesium deficiency, often as a result of long-term
proton-pump inhibitor use •
Menopause •
Mercury poisoning •
Migraines •
Multiple sclerosis •
Nerve compression syndrome •
Obdormition •
Oxygen toxicity, especially breathing oxygen under pressure, such as in scuba diving •
Pyrethrum or
pyrethroid pesticides •
Post-polio syndrome •
Rabies •
Radiation poisoning •
Sarcoidosis •
Sciatica •
Scorpion stings •
Spinal disc herniation or injury •
Spinal stenosis •
Stinging nettles •
Syringomyelia •
Transverse myelitis •
Variant Creutzfeldt–Jakob disease (AKA "mad cow disease") •
Vitamin B5 deficiency •
Vitamin B6 excess •
Vitamin B12 deficiency ==Diagnostics==