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NUMBNESS HAS MANY CAUSES

Q: My son is 42 years old and is having numbness in different parts of his body. He also has pain in his head that goes down to his mouth and causes numbness.

When he was born he had a large hematoma on his head due to coming through the birth canal too quickly. I'm wondering if this could contribute to the problem he is now having.

He is also under a lot of stress with his position and has a few other problems. His doctor is treating him with Paxil for anxiety. Any information you can give would be appreciated.

-- K.D., Ridgeley, W.V.
A: Hematomas (large bruises) are not uncommon in difficult births, and they typically go away completely without causing any future problems.

I would need more information to determine the cause of your son's numbness. In particular, it is very important to know exactly where it is located, whether it comes and goes or is it permanent, and whether anything he does makes it worse or better. But, by providing some background knowledge, I hope I can help you both understand the situation better.

The problem starts with very small sensors just below the surface of the skin. When stimulated, these sensors send electrical signals through nerves to the spinal cord or directly to the brain. The signal is relayed to many different places in the brain, one of which detects the sensation. Numbness can be caused by a malfunction at any one of these steps.

Malfunction of the sensory system can be caused by generalized diseases such as diabetes or multiple sclerosis. Typically, numbness in someone with diabetes starts slowly in the lower legs and does not come and go throughout the day.

Multiple sclerosis can cause many different patterns of sensations, including numbness. Early in this disease the changes typically come quickly and then go away over the course of days, weeks and sometimes months. The problem may return to the same area, but this is often years later. People with multiple sclerosis have a much high risk of developing pain in the temple area, which then can lead to numbness in the face. But, here, too, it typically goes away within a few weeks and does not return for months or years.

The most common cause of numbness is pressure on a nerve as it carries an electrical signal to the brain. One common cause is pressure from a bulging disc in the spinal cord. Another occurs when a person's leg "goes to sleep" after sitting in an abnormal position or simply sitting normally for a long time.

Tumors of the brain and spinal cord can cause numbness, but they are not common and the numbness would almost always be continuous once it started.

Finally, tingling and numbness can be a symptom of anxiety attacks, especially if they are associated with breathing too hard (both fast and deep). This is called hyperventilation, which depletes the body of too much carbon dioxide and causes the tingling and numbness. A simple way to test this (and it's used as a treatment also) is to cover the mouth with a paper bag when breathing heavily.

Given that your son is under a lot of psychological strain, the doctor's conclusion is reasonable. But I don't know how much detective work your son and his doctor went through before deciding that his numbness was due to anxiety.

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