Doctors Lounge - Neurology Answers
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Forum Name: Neurology Topics
|avaldez99 - Thu Feb 02, 2006 1:25 pm||
I have facial numbness on the left side of my face which is constant for about a year already. The numbness seems to be very mild when I’m relax. Under stress I get strong facial numbness on the left side of my face with some times tingling. The numbness sometimes is not on my entire left side but half sometime. The numbness began when I was under a lot of stress and went away for a couple of months then returned. I had a MRI which came out clean no abnormalities. Dr prescribed topmax but I did not take the medication since it made my hands numb/tingling. Went back to complain to Neurologist, said it was stress and prescribed anxiety drug lexapro. I did not want to take these pills because I don’t want to be on these anxiety/depression pills. I don’t feel depressed at all. Stress maybe. What do you think I may have. I will be getting a second opion next month with another Neurologist.
|Dr. Tamer Fouad - Sat May 20, 2006 6:44 am||
Paresthesiae of the mouth, hands and feet are common, transient symptoms of the related conditions of hyperventilation syndrome and panic attacks.
Symmetric peri-oral numbness is common in cases of hypocalcaemia and is an accompanying symptom in migraine suffering people that may precede the headache itself.
Symmetrical or unilateral affection of the face is common with cervical disc lesion. In disc disease or spinal arthritis the nerve roots are compresses (radiculopathy) leading to paresthesia that is felt according to the level of affection.
While in a condition named trigeminal nerve neuralgia (fifth cranial nerve) there is unilateral sensory paresthesia of the face followed later on by sensory loss and trophic changes.
Other causes include disorders affecting the central nervous system. These include stroke, transient ischemic attacks (TIAs or mini-strokes), multiple sclerosis, transverse myelitis, and infections (encephalitis). A space occupying lesion (tumor or vascular) that causes compression on the brain or spinal cord can also cause paresthesia.
I am glad your MRI came out normal.
In general the management of paresthesia is proper diagnosis and management of the underlying cause.
In cases of nerve compression Once the nerve is decompressed and the circulation is improved the numbeness and tingling sensations will disappear quickly. This can be enhanced by by stretching, exercising, or massaging the affected limb.
In the case of Diabetes Mellitus or as a side effect of treatments such as chemotherapy, treatments are aimed at relieving symptoms.
- In mild symptoms: anti-inflammatory drugs such as aspirin or ibuprofen can be of help.
- In more complicated symptoms:
1. Antidepressant drugs are prescribed by some doctors at a much lower dosage than those of depression. They are thought to help because they alter the body's perception of pain.
2. In severe symptoms, opium derivatives can be used.
Other treatment alternatives can help to relieve symptoms of paresthesia and include supplementation with B complex vitamins in cases of vitamine diffeciency, especially vitamin B 12 (intramuscular injection of vitamin B12 is most effective). Caution should be taken since overdose of Vitamin B6 results in paresthesias.
General measures that can be considered include:
- Alcohol intake should be avoided in people experience paraesthesias since it aggrevates the sensory disturbance.
- Acupuncture and massage have been used by some to relieve symptoms.
- Self-massage with topical ointments or oils can alleviate symptoms in some.
- To wear loosely fitting shoes and clothing can be helpful.
Of note none of the general measures can replace specific therapy for the underlying cause.
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