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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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I have left side facial numbness - cheek and around lower part

Resolved Question:

I have left side facial numbness - cheek and around lower part of eye which twitches occasionally. No pain - Very slightly swollen. Left ear is affected too.
Slight intermittent headaches. Slight Occasional light headed and disoriented sensations. Parents had stroles. I am worried.
Submitted: 2 years ago.
Category: Neurology
Expert:  Dr. Frank replied 2 years ago.

neuromd2012 :

HI

neuromd2012 :

I am an adult neurologist, and will attempt to answer your question. You are offline, so please review the following information and ask questions if you have them , or if you are asked to answer my questions, please do so and I will return to reply. If you feel you have recieved enough information and are satisfied, please hit the accept button as that is how I am compensated for my work. If you have additional questions, even after you have hit the accept, for example you now have lab results, please return and I will be glad to answer your questions. Please be aware that as a physician I cannot make a diagnosis without an examination, so this is for information purposes only and does not adhere to the role of a patient-physician relationship. Ok?

neuromd2012 :

You symptoms that you describe are left sided facial numbness, in around the cheek and lower part of the eye, that is clearly a V2 distribution of the trigeminal nerve, and suggests a peripheral nerve problem. You mention that your face is very slightly swollen and that your left ear is also effected

Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience: Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
Dr. Frank and other Neurology Specialists are ready to help you
Expert:  Dr. Frank replied 2 years ago.

hi We were on the chat line, and I was hoping to chat with you about this, but you hit the accept button which disconnected us and ended our chat. I will continue, please reply in the box you see, and I will return to answer your questions, ok?

So I was wondering if you have a fullness sensation in your ear? could you have an ear infection and with that lightheadedness or true vertigo? and a disorientation sense as you describe it, or are you confused and having problems generating language and speech? Anyway, it sounds like an ear infection or tooth infection (upper jaw) and with that you have affected your sensory nerve to your face. You need to go see a regular doctor your gp, to look in your ear and mouth for signs of infection and swelling. Please get back to me if you disagree and we can discuss. Dr. Frank T.

Customer: replied 2 years ago.
I don't know why this site will not accept my Email address. It says someone else is registered using it. Perhaps you could check. otherwise we can continue like this. Thanks.

MORE INFO - Yesterday my periodontist checked my 6 month old surgery and said all is well. ( It WAS left upper jaw) EAR fullness could be the result of long airline flight a week ago but the numb face was present before the flight. None of this is painful.
NO problem with speech.( I expect occasional lost words are age related)
Left side of nose is now affected. The allover sensation feels as if a dental freezing is nearly out!
In addition - Left thumb and forefinger are slightly numb also the front of left thigh. (maybe pinched nerve from long flight and driving (stress?) holiday in Italy.
Yesterday GP checked my hand grip, mouth and ear as OK.
I feel fragile. More information PLEASE
Expert:  Dr. Frank replied 2 years ago.

Well you need imaging, there could be something causing inflammation in your left maxillary sinus like a mucocele that became inflamed with the airtravel/pressure change and traveling in Italy (lucky dog). but clearly if it stays in the V2 distribution of the nerve, and I will attach a picture to this webpage, and you say your face is swollen, even if just slightly, then I cannot implicate a stroke ( I mean, a lacunar stroke in the right thalamus of your brain could cause a pure sensory deficit on your face and left hand/arm, but it would be your entire left face below the chin to the neck) and there might also be pain.

 

An MRI with attention to the gasserian ganglion on the left (facial sensory ganglion) is what you need. Look for localized inflammation. Again, I cannot be certain without seeing you and an exam. One thing you could try is get a cue tip and pull the cotton out a bit to get just a hair exposed or use a make up brush with a single hair, close your eyes and try to map out the exact limits of the numbness on your face, compare it to the attached map of facial sensation and see if it fits V2 distribution (dark yellow). A Neurologist could certainly help you with this problem, there are also a facial sensory test called the blink response test done in his office to test the trigeminal nerve in that area, and he would schedule the MRI.

 

I hope I helped answer your question, please reply or hit the accept button if you are satisfied as that is how I get compensated for my work. thank you. Dr. Frank T.

 

http://face-and-emotion.com/dataface/anatomy/sensation.jsp

Customer: replied 2 years ago.
thank you Dr Frank,
This gives me a way forward.
Did you attach the map for facial sensation? I did not get it.
C.
Expert:  Dr. Frank replied 2 years ago.
sensory innervation in the face
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience: Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
Dr. Frank and other Neurology Specialists are ready to help you

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