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I am very scared that I have small fiber neuropathy

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Hello, I am very scared...
Hello, I am very scared that I have small fiber neuropathy effecting my face. What symptoms would be involved in this?
Thanks,
Kris
Submitted: 4 months ago.Category: Neurology
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Answered in 3 minutes by:
12/11/2017
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago
Dr. Huynh
Dr. Huynh, Board Certified Physician
Category: Neurology
Satisfied Customers: 125
Experience: Assistant Director / Medical Officer at Howard University
Verified

Good morning, I'm Dr. Huynh, a board certified physician. Welcome to JustAnswer! Please allow me a moment to review your responses and I will reply shortly.

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Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago

I'm sorry to hear about your concern. The face has several nerves and pathways for it. Neuropathy can generally be a numbness and tingling sensation in a specific area. Can you please describe what you are feeling and where?

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Customer reply replied 4 months ago
Hello,
My face feels tight, my eye muscles feel tight and it feel sensitive. My eyes have sunken in and I’ve lost fat on my face. I am so scared I don’t know what to do?
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago

Is the sensation on both sides of the face? is there any rash, discoloration, or swelling? Are you on any medications?

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Customer reply replied 4 months ago
sensation on both sides. No rash discoloration or swelling. I just started a course of prednisone hoping it would help?
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago

Prednisone could be helpful. It is a strong medication used for many purposes. Do you have any other past medical history that can give insight? Do you take medications for any other reason?

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Customer reply replied 4 months ago
It is my 4th day on Prednisone and it’s not helping, yet. I don’t take any other medications.
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago

Is there any other part of your body that has a symptom?

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Customer reply replied 4 months ago
I don’t have any pain anywhere. I do get weak muscles and some tingling sometimes.
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago

Thank you for your responses. Neuropathy of the face generally affects one side. It normally does not affect both. Most syndromes will usually have other symptoms as well but yours is very localized to both sides of the face. Prednisone is a good first start and I hope you start to see some improvement over the next couple days. In addition, take a look at any over the counter products you may be using and stop using them for now, including make up, cleansers, creams, and lotions. Sometimes, these products can cause small reactions on our skin that lead to inflammation and a feeling of tightness. If your symptoms persist after the prednisone, you should see a Neurologist for further evaluation in person and possible blood tests.

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Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago

If you have any questions, please let me know. Otherwise, please take a moment to rate me a 5, or let me know how I can improve.

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Customer reply replied 4 months ago
Does small fiber neuralgia only effect one side of the face? What would be causing the fat loss and eye stiffness? How should the Prednisone help? I am really scared especially about the fat loss. It’s awful! What would cause that? Would small fiber neuropathy have any chance of causing it?
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago

Yes, any nerve issue in the face usually affects one side because of the way the nerve pathways are developed. Small fiber neuropathy is usually slow to develop and is often described as burning pain, shooting pain, numbness, or tingling. If You feel like this came out of the blue, then it is another reason to suspect this is something else. Optic neuritis could be a possibility but that also is normally one eye, not both.

If you are losing fat in other areas like your clothes are getting looser, then losing fat in the face is appropriate. But, if you are only losing fat in the face, it would be difficult to tell if you are losing muscle because of nerve degeneration or if you are really losing fat. Localized fat loss is not common.

Prednisone is a champion for decreasing inflammation for many types of syndromes. If this is a nerve inflammation, it's possible that prednisone will help calm the nerves down enough to begin healing. But, if it doesn't, you'll need a Neurologist to further evaluate your face to get to the bottom of this.

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Customer reply replied 4 months ago
This has gotten worse with time for sure. I am really scared. This is not normal. I feel like I am losing both muscle and fat. This started happening after a Botox injection.
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago

That is an important piece of information. When was this and where was it injected?

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Customer reply replied 4 months ago
It was in 2013 and it didn’t start right away. When I told doctors about it they either disregarded it or didn’t know what to do. I had one Dr say it would wear off when the Botox was gone. It’s bad and I don’t know what to do. I just want my face back.
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago

Did you have any injections recently ?

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Customer reply replied 4 months ago
No, I have not had any since then.
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago

If it was from the botox, the signs & symptoms would have abated once the toxin wore off. My recommendation for you is still the same - try the prednisone and if it doesn't work, you should see a Neurologist for further testing!

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Customer reply replied 4 months ago
SMFN could do this? Can my face restore if that’s the case.
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago

No, I don't believe small fiber neuropathy can do this.

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Customer reply replied 4 months ago
Do you have any idea what it could be?
Thanks
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago

Without any other symptoms, there is not much that fits what you're describing. It seems there is a sensory issue with multiple nerves in your face. A neurologist can test the nerves to see if they are in fact causing the issue.

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Customer reply replied 4 months ago
I am a little confused now. So a nerve issue could be causing the fat loss? What kind of nerve issue or diagnosis would this be. I just want to get better.
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago

I'm sorry for the confusion. There is no diagnosis at this time. A neurologist can test the nerves in your face to see if it is the cause for your symptoms. If they are not the cause, then they would need to do other tests to help you.

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Customer reply replied 4 months ago
What kind of tests would this be and what kind of nerve issue would cause this?
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago

There are nerve conduction tests and electromyelograms. It would be to detect any kind of nerve issue - degeneration, irritation, slowness, for example.

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Customer reply replied 4 months ago
that would cause the fat loss?
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago

After a long period of time, it's possible.

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Customer reply replied 4 months ago
I am going crazy now! Can this recover?
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago

It depends on whether you find the cause and if the cause is treatable. For example, if a nerve is compressed by a piece of fascia, and the fascia is cut, then the nerve can heal. But if there is no reason for the nerve to degenerate, then there may not be recovery - there may only be management. You need to find the diagnosis first before you can determine the outcome.

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Customer reply replied 4 months ago
I have never been so scared in all of my life. I feel like I can’t go on with no hope. What would cause this?
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago

I'm sorry to hear that this is really causing you distress. You should visit a Neurologist in person as soon as possible to get help! Unfortunately, I am unable to assist you further than what I've mentioned above.

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Customer reply replied 4 months ago
Can Prednisone agitate nerves or muscles. I feel like I am having more muscle tightness in my eyes and tingling in my hand.
Thanks!
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago

No, it should not affect the nerves or muscles in that manner. Prednisone can cause some swelling though.

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Customer reply replied 4 months ago
Where would the swelube located? Thanks
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago

The swelling would mostly be in the hands and feet. Some people may feel bloated in their bellies and face.

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Customer reply replied 4 months ago
Hi, sorry I have been having increased numb tingling feeling in my arms, legs and across my face like I had right after the Botox. I read this can be a side effect of Prednisone? What is happening ? I also have more tightness in my eye muscles and face.
Thanks
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago
Good evening, prednisone doesn’t usually cause that side effect. I recommend you seek medical attention locally so you can be evaluated thoroughly.
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Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago
If you have any other questions about neuropathy, let me know. otherwise, please rate me a 5 or let me know how I can improve.
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Customer reply replied 4 months ago
Hi, thanks again. I saw this yesterday on the Mayo Clinic website. The tingling is listed and I am also having gastritis type symptoms. Is it possible to come off of the prednisone. ? These things are concerning me.
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago

Good morning, coming off prednisone can be done safely but also can be medically dangerous. I recommend you seek medical attention locally so you can be evaluated thoroughly. Thank you for using JustAnswer. Please rate me a 5 or let me know how I can improve.

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Customer reply replied 4 months ago
Hi, sorry to keep dragging this out. I am tapering off of the prednisone. I started having horrible anxiety.
I am very concerned about my face and don’t have an appointment with a neurologist till 1/10. I am really concerned about the fat/ tissue loss and tight feeling in my face. Is there anywhere I could get testing done soonwe? This is really weighing on my mind and scaring me that I might have permanent damage and the fat won’t come back. Thanks
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago
Good evening, you’d have to search your local area for physicians with appointments sooner. Thank you for using JustAnswer. Please rate me a 5 or let me know how I can improve.
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Customer reply replied 4 months ago
Do you have any idea if it sounds like damage?its hard to get through each day because I am worried. Thanks!
Neurologist: Dr. Huynh, Board Certified Physician replied 4 months ago
Good evening, please review our conversation as this has been covered. You can open a new question requesting a second opinion. Have a good night.
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