Question: I frequently have altered sensation and temperature perception in my right hand and arm. And one or both arms are often numb when I wake. What’s the problem?
Answer: Numbness or tingling in an arm during sleep is usual-ly caused by pressure on a nerve, not poor circulation as is commonly believed. When one arm is affected, the pressure is often caused by a favorite sleeping position—for example, tucking your hand under your head or pillow. In that case, the numbness would disappear within a minute or two after you relieve the pressure. However, if the problem strikes both of your arms or either one during waking hours, you should be evaluated by a physician for other possible disorders, including disc disease or arthritis of the neck.
Question: I have essential tremor, which makes it hard for me to write. Is there any treatment for this condition?
Answer: There’s no cure for essential tremor, which may be genetically caused and can occur at any age. However, daily doses of the beta-blocker propranolol (Inderal) and the anti-convulsive drug primidone (Mysoline)—taken alone or together—can reduce the intensity of tremors, typically by about half. Wrist-strengthening exercises can also help stabi-lize the hand, making it easier to write. In addition, try to avoid caffeine, certain asthma medications, oral decongestants, and stress, all of which can make the tremor worse.
SCIATICA AND NUMB TOES
Question: Last year I had sciatica from my back down to my right leg. The pain cleared up but left me with a kind of numbness in three toes (big toe and adjacent two) that I can’t seem to shake. What can I do about this ?
Answer: Your numbness probably stems from some chronic irritation of the sciatic nerve root as it leaves the spinal cord. This may be caused by a herniated, or “slipped,” disk, a disk fragment, or a bone spur. Unfortunately, the longer the numbness lasts, the less likely it is to disappear. A consultation with a neurologist would be advisable.
Question: What are the cause and treatment of “slap foot,” which makes the front of the foot slap down noisily when walking?
Answer: Slap foot, or what doctors call a slapping gait, results when something goes wrong with the nerves controlling the muscles in front of the lower leg. The weakened muscles can’t lift the forefoot, which hits the ground before the heel. The problem could be caused by a bulging or herniated inter-vertebral disk or a bone spur pressing on the spinal cord. It could also be caused by a damaged or inflamed nerve supplying the front part of the leg. Treatment depends on identifying the cause. If no treatment is effective, a brace can be helpful.
TREATING A TREMOR
Question: Are there any vitamins, minerals, or specific foods that might help the condition known as “benign essential tremor”?
Answer: The medical term “essential” is often applied to com ditions for which the cause is not known, and that unfortul nately is the case with this troublesome neurological ailment. It sometimes runs in families, so there may be a genetic com- ponent. Unfortunately, there is no evidence that any nutr-tional therapy will improve this trembling of the hands, face or voice. Small quantities of alcohol may temporarily suppress it, and beta-blocker drugs (such as propranolol or nadolol) frequently help. The anticonvulsant primidone (Mysoline) is also effective in some patients. In addition, one study with a small number of patients found about half responded well to a drug called methazolamide (Neptazane), also used for glau- coma. However, those medications help the tremor only as long as they’re being used. It may be more helpful to mini-mize intake of substances that can worsen tremors, such as caffeine, certain drugs for asthma, and oral decongestants.
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