Hypesthesia

Hypesthesia

Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Hypesthesia refers to sensory loss that usually occurs secondary to a problem in the nervous system. Usually coupled with paresthiasis (an abnormal sensation; e.g. tingling or numbness)

Differential Diagnosis

In alphabetical order.

• Aura of migraine
• Brainstem lesion
• Cauda equina syndrome
• Cerebral abscess
• Cortical lesion
• Deficiency status
• Inflammatory peripheral neuropathy
• Inherited peripheral neuropathy
• Metabolic peripheral neuropathy
• Mononeuropathy
• Myelopathy
• Paraneoplastic neuropathy
• Plexopathy
• Radiculopathy
• Simple partial seizure
• Subcortical lesions
• Syringomyelia
• Toxic peripheral neuropathy
• Transient ischemic attacks

History and Symptoms

• Onset (tempo)
• Distribution of paresthesias or hypesthesia

Laboratory Findings

• Complete blood count (CBC)
• Serum protein electrophoresis (SPEP)
• Rheumatoid factor
• Antinuclear antibody
• HIV
• Rapid plasma reagin (RPR)
• Vitamin B12
• Thyroid function tests
• Folate
• Heavy metals
• Hemoglobin A1c

MRI and CT

• CT scan is used for initial screening
• MRI offers the best imaging

Other Imaging Findings

• Electromyogram

Other Diagnostic Studies

• Nerve conduction studies
• Genetic testing

Treatment

• Treat underlying etiologies
• Alleviate offending causes
• Physical therapy

Pharmacotherapy

Acute Pharmacotherapies

• Tricyclic antidepressants
• Anticonvulsants
• Topical preparations
• Epidural injections
• Steroids
• Interferon
• Glatiramer acetate
• Mitoxantrome

Surgery and Device Based Therapy

• Surgical intervention for compressive myelopathies and some cases of radiculopathy

Acknowledgements

The content on this page was first contributed by Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]