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Dr. Bob
Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 3977
Experience:  Neurology & Int Medicine (US Trained): 20 yrs experience
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I have numbness/tingling on the left side of my face and into

Customer Question

I have numbness/tingling on the left side of my face and into my eye, and sonetimes the top/back of my head. Sometimes I get the sensation of coldness in my cheek, but it isn't cold to touch. My eye has started feeling a bit strange (tingly) as well. Previously, the numbness was also in my left forearm, but that seems to have gone away. I have had an MRI of my brain and cervical spine, which showed arthritis in my neck and nothing else. My doctor says if this was from the arthritis, it would be on the right and not the left. I have no drooping of my eye or facilal muscles. GP's neurological exam only showed some stiffness in my neck, everything else was fine. Every now and then I get optical migraines (just the jagged colored lines, no pain) which go away within a few minutes. I work on the computer all day, but my work station was already changed so that it would be ergonomically correct since I had tennis elbow (that was many years ago). I also had a carotid ultrasound, which was normal, and I have low cholesterol. I take cholestryramine in the morning, and before bed I take zyrtec, citalopram, lisinopril with hydrochlorithiazide, an aspirin, multi-vitamin, and calcium with D. Any ideas what could be causing this?
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Bob replied 1 year ago.
Hello. How often do you get this numbness and tingling in your face and eye? How long does it typically last? Do your optical migraines occur on the same side?
Customer: replied 1 year ago.

The jagged colored lines are around both eyes. My optometrist said they were optical migraines; no pain in my head when I get them.


 


The numbness/tingling in my face has been that way for a month or more. It started with face and forearm and was intermittent for a week or so. Then it was constantly there. Now, it is still constantly there, but the arm portion seems to have gone away. Sometimes it feels like my left eye is watering, but if I go to wipe it, it is dry.

Expert:  Dr. Bob replied 1 year ago.

The distribution of your symptoms on the left correspond to the opthalmic branch of the 5th cranial nerve (i.e. the trigeminal nerve). This nerve supplies sensation to the face, including the eye, and the top of the head. We have one on each side.

 

This nerve is commonly irritated and can fire inappropriately causing pain or abnormal sensations known as paresthesias. When pain fibers are involved, it can cause a very uncomfortable condition known as trigeminal neruralgia. When non-pain fibers are involved (including the temperature fibers) the sensations are not necessarily painful but very annoying, and sometimes downright distressing. They include numbness, tingling, cold or heat sensations, even a sensation of "insects crawling" across the skin.

 

Problems with this nerve are more common in migraine sufferers, so the condition is probably related to your optical migraines. At any rate, a normal MRI essentially rules out a mechanical cause (e.g. tumor, stroke). This is true for the vast majority of such cases. While the exact cause is usually not found, most cases resolve over the course of several weeks to months, once the nerve calms down.

 

In the meantime, you could ask your doctor about using a nerve-stabilizing medication such as gabapentin, pregabalin, or carbamazepine to calm the nerve and expedite its return to a more normal state.

Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 3977
Experience: Neurology & Int Medicine (US Trained): 20 yrs experience
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Customer: replied 1 year ago.

Thank you. A nurse friend of mine suggested that may be the problem, also, but I wanted to hear it from a neurologist that I did not have to go get another opinion, since my GP kind of just left everything hanging once the tests came back normal.

Expert:  Dr. Bob replied 1 year ago.
Your nurse friend is pretty sharp. :-)
Customer: replied 1 year ago.

I do have one question. I had the numbness and tingling in my left arm for most of the time it originally appeared. Would this still be related to the trigeminal nerve?

Expert:  Dr. Bob replied 1 year ago.
The arm tingling would not be related to the trigeminal nerve directly. It would have had to have been merely coincidental (which seems unlikely) or indirectly related, such as from excess neuronal stimulation in the upper cervical spinal cord (which is fairly close to the trigeminal nuclei in the brainstem), or from anxiety, which often provokes tingling in the arms, legs, lips, etc.

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