parestesie

Parestésie, sometimes written paresthesie, refers to an abnormal sensation described as tingling, pricking, or a crawling feeling, often described as pins and needles. It is usually felt in the hands or feet but can occur elsewhere. Paresthesias can be transient, lasting only moments, or persistent, indicating an ongoing issue with nerves or blood flow.

Causes are diverse and can be categorized as focal or generalized. Common, reversible causes include temporary nerve compression from prolonged sitting or sleeping in an awkward position, carpal tunnel syndrome, or radiculopathy. Chronic paresthesias may result from peripheral neuropathy due to diabetes, vitamin deficiencies (notably B12), alcohol-related nerve injury, or autoimmune conditions. Medications, especially certain chemotherapy agents or other neurotoxic drugs, can contribute. Central nervous system conditions such as stroke, transient ischemic attack, or demyelinating diseases like multiple sclerosis can also cause paresthesias. In some cases, injuries or surgeries affecting nerves are responsible.

Symptoms vary but typically include tingling, prickling, numbness, burning, or crawling sensations. They may be localized to a area or widespread and can be accompanied by weakness or loss of coordination if motor nerves are involved. Red flags include sudden onset with facial weakness, speech or vision changes, severe headache, or limb weakness, which may indicate a stroke or another urgent condition.

Diagnosis begins with clinical evaluation and history. Tests may include blood work (glucose control, vitamin B12, thyroid function), nerve conduction studies and electromyography, and imaging such as MRI if a structural cause is suspected.

Treatment targets the underlying cause. Addressing nerve compression, correcting nutritional deficiencies, and managing diseases like diabetes can reduce or resolve symptoms. When neuropathic pain is present, medications such as gabapentinoids or duloxetine may be considered, often alongside physical therapy and lifestyle adjustments. Prognosis depends on the cause; many transient paresthesias improve, while persistent cases require ongoing management.