HNPP causes episodes of numbness, tingling and/or weakness in response to nerve injury from pressure, stretching or repetitive use. Things that cause these symptoms usually would not affect a normal individual. When injured, the nerves demyelinate or lose their protective covering. This demyelination is what causes the episodes of numbness and weakness in the injured area. The numbness and weakness is referred to as a pressure palsy'. In time, the nerves recover, or partially recover and remyelinate.
These episodes of numbness and weakness can be as brief as a few minutes, but may last several days or even several months. Two to three months seems to be the most common duration of a "long" pressure palsy, but 6-12 months is not unheard of. Numbness may be as mild as the individual noticing that an area or limb does not have quite the same feeling as surrounding areas or the other side. Or the numbness can be so severe as to feel like the area or limb has been shot full of Novocain. Weakness also can vary between slight and so severe that the individual is, depending on the location of the pressure palsy, unable to move a particular muscle group or the entire limb. A pressure palsy in the hand can result in not being able to hold a pen, much less write; not being able to hold a bar of soap; not able to use a knife to cut, to put on socks, button buttons, do zippers or any number of fine motor activities. A pressure palsy in the arm may result in the arm being totally useless. Another whole arm problem can involve not being able to use the arm if it is way form the body, or if the elbow is not tucked into one's side. This makes activities like eating, reaching and washing hair impossible, or nearly so. A leg palsy can make walking, driving or climbing stair nearly or completely impossible. Dragging a leg during a palsy is not uncommon.
The numbness and weakness may gradually go away or it may remain severe for quite some time and then rapidly get better. And sometimes the numbness and weakness may only partially improve, meaning there is permanent nerve damage. There is no way to tell at the beginning of a pressure palsy whether there will be noticeable permanent damage or not. Wiht a pressure palsy, it really is "only time will tell". The amount of time the nerve is compressed seems to play a role in the severity of symptoms.
HNPP can vary greatly in severity and cause very different symptoms even within the same family. It can also cause different symptoms within the same individual! Symptoms can come and go. In approximately one third of people who are diagnosed with HNPP no other family members are recognized to have the disorder. HNPP is also a great imitator of common disorders acquired later in life such as carpal tunnel syndrome. It's no wonder that HNPP can be hard to diagnose and the majority of individuals do not even know they have it.
Examples of activities that cause symptoms of numbness, tingling and weakness are:
There are other symptoms which people with HNPP are reporting (Note: This does NOT mean that everyone with HNPP will develop these symptoms). Many of these are typical symptoms of anyone who has a generalized neuropathy.
As people with HNPP meet on the Internet, they tend to compare other symptoms and problems which they are experiencing. These problems range from headaches to digestion to bladder problems, etc. It is not yet known if these problems are indeed related to HNPP. More medical studies need to be done. This is not to say that discussions should not continue. But all problems that a person with HNPP is experiencing, should be reported to the attending neurologist and the neurologist involved in any studies in which the person is involved.
Last updated: 2/01
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