Title:Acroparesthesias: An Overview
Volume: 20
Issue: 2
Author(s): Maroua Slouma, Siwar Ben Dhia*, Elhem Cheour and Imen Gharsallah
Affiliation:
- Department of Rheumatology, Military Hospital, Tunis, Tunisia
- Department of Medicine, Tunis El Manar University,
Tunis, Tunisia
Keywords:
Acroparesthesia, carpal tunnel syndrome, ultrasonography, Guillain Barré, polyneuropathy, diabetes.
Abstract:
Acroparesthesia is a symptom characterized by a subjective sensation, such as numbness,
tingling, prickling, and reduced sensation, affecting the extremities (fingers and toes). Despite
its frequency, data regarding its diagnostic approach and management are scarce. The etiological
diagnosis of acroparesthesia is sometimes challenging since it can be due to abnormality anywhere
along the sensory pathway from the peripheral nervous system to the cerebral cortex.
Acroparesthesia can reveal several diseases. It can be associated with rheumatic complaints such
as arthritis or myalgia.
Further cautions are required when paresthesia is acute (within days) in onset, rapidly progressive,
severe, asymmetric, proximal, multifocal, or associated with predominant motor signs (limb weakness)
or severe dysautonomia. Acroparesthesia may reveal Guillain-Barré syndrome or vasculitis,
requiring rapid management.
Acroparesthesia is a predominant symptom of polyneuropathy, typically distal and symmetric, often
due to diabetes. However, it can occur in other diseases such as vitamin B12 deficiency, monoclonal
gammopathy of undetermined significance, or Fabry’s disease. Mononeuropathy, mainly
carpal tunnel syndrome, remains the most common cause of acroparesthesia.
Ultrasonography contributes to the diagnosis of nerve entrapment neuropathy by showing nerve
enlargement, hypoechogenic nerve, and intraneural vascularity. Besides, it can reveal its cause,
such as space-occupying lesions, anatomical nerve variations, or anomalous muscle. Ultrasonography
is also helpful for entrapment neuropathy treatment, such as ultrasound-guided steroid injection
or carpal tunnel release.
The management of acroparesthesia depends on its causes.
This article aimed to review and summarize current knowledge on acroparesthesia and its causes.
We also propose an algorithm for the management of acroparesthesia.