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Paresthesia is not a disease, but a symptom of a condition that may be temporary or long-lasting. Paresthesia is a common symptom that refers to a prickling or burning sensation in some parts of the body, usually the arms, hands, legs, or feet. These can also occur in other body parts of the body. This unusual sensation often happens without warning, and is typically painless. It may occur suddenly or gradually, but sometimes it may come and go. Other descriptions for paresthesia include tingling, numbness, itching, or skin crawling.

Many people experience temporary feelings of "pins and needles" some time in their lives, especially when they have fallen asleep or assumed a position where pressure is applied on their arm or leg for quite a while. Trauma, such as a bone fracture that results in nerve impingement, can also cause paresthesia. Sustained pressure on a nerve causes paresthesia, but this feeling quickly goes away when pressure is released.

Another common cause of tingling, especially in the hands, is hyperventilation, which occurs during an acute anxiety attack. Relaxing and breathing into a paper bag usually relieves this transient symptom.

Chronic or persistent paresthesia occurs when a nerve is damaged or compressed due to an underlying disease. It can be caused by any of the following:

Disorders in the central nervous system (affecting the brain and spinal cord), such as:

  • A stroke and or mini-stroke
  • Infections, such as encephalitis
  • Demyelinating diseases such as Guillain-Barre syndrome and multiple sclerosis
  • Transverse myelitis
  • Tumors
  • Vascular lesions (abnormalities in the blood vessels) pressing against the brain or spinal cord

Disorders affecting the peripheral nerves, such as:

  • Nerve entrapment syndromes, like carpal tunnel syndrome, where peripheral nerves are damaged, causing paresthesia and pain.
  • Complications of chronic disease, such as diabetes and atherosclerosis, which cause neuropathy due to poor circulation
  • Malnutrition and vitamin deficiencies
  • Disorders of metabolism, such as thyroid gland disease
  • Infectious diseases that attack the nerves, such as herpes zoster

A less common cause of paresthesia is formication, which is a tactile hallucination or an abnormal sensation in the skin that is described as similar to that of crawling insects within or over the skin. It may result as a side effect of substance abuse (cocaine, methamphetamine, crystal meth, Ecstacy), use of some prescription drugs (Adderall, Lunesta, Ritalin), or extreme alcohol withdrawal. It may also be caused by a delusional belief of parasitosis, wherein one believes he is infested with parasites or bugs that crawl under or over their skin. These patients usually consult various doctors and often complain about the advice they receive, thus treating them with hostility or suspicion.

If you are experiencing persistent paresthesia, consult your doctor for proper evaluation and treatment. A complete work-up including history taking, physical examination and laboratory tests may be needed to determine any underlying condition that may be causing your symptoms. Depending on the suspected cause of your paresthesia, your physician may order additional specific tests or give you a referral to a specialist. Treatments will vary accordingly.

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