Hypesthesia

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

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
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