Is cold numbness normal after a TIA?

Graygraduate asked...

On Jan. 4, 2010 I had a stroke (TIA). It left me with numbness in my right hand, thumb, and forefinger. It also left my lips and tongue feeling as if they are freezing, and this also affects my thumb and forefinger. Sometimes the sensation is so great I need to put warm compresses on my face just to calm down the sensations. Is this normal?

Expert Answer

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

It sounds as if you suffered a stroke, not a TIA. A TIA, by definition, resolves completely. Your symptoms have not, so this would be a stroke.

It is not uncommon after a stroke to suffer such phantom sensations. When the nerve pathways are interrupted, your brain begins to make up sensations to fill the void from the damage. Often, these are quite uncomfortable. If you have ever seen a civil war movie, there is almost undoubtedly a scene where one of the soilders has lost a leg from amputation, and starts complaining that his foot feels cold - only, he has no foot! Your situation is very similar. The brain is simply making up sensations from areas where the sensory pathways have been damaged.

If this does not get better, and is bothersome to you, ask your doctor about trying one of three medicines: 1) amitriptyline, 2) gabapentin, 3) pregabalin. I have had success with each of them for this type of problem. I would start with one of the first two, as they are much less expensive than the third.

Good luck!