Uncomfortably Numb
November 22, 2007 1:49 PM   Subscribe

Numb right hand side of face- MRI and blood scans show nothing- experiences/suggestions?

My SO is looking for the wisdom of strangers on the web as the doctors have came up with nothing. Basically she has had a numb cheek/ right hand side of face. Extensive checks (MRI and blood scans) have turned up no reason.

Full disclosure- suspicious lump on back of the neck developed shortly before numbness but docs don't think significant. Smoker. Excercises regularly. General health good. Work requires sitting in front of lap top and using mobile.

Thoughts, theories and experiences appreciated.
posted by Gratishades to Health & Fitness (18 answers total)
Bell's Palsy?
posted by ClaudiaCenter at 2:11 PM on November 22, 2007

I do not know the degree of numbness that your SO, so PLEASE take this into consideration:

1) I knew someone who had slight numbness on one side of her face. Emergency found nothing; his GP found nothing. Was sent to a neurologist who ordered an MRI which also found nothing.

Based on these results (or lack of results), the neuro suggested that it might be nothing but a virus that was causing this feeling in my friend's face.

2) I sit in front of a computer 10-12 hours a day, sometimes 7 days a week and the back of my neck (near the shoulder blade) gets tingly sometimes (never my face though). I attribute this to my head immobile in one position all day.
posted by bitteroldman at 2:12 PM on November 22, 2007

A referral to a neurologist would be the first thing I'd insist on. If a neuro is one of the doctors you've seen, I can't believe they'd stop investigating there. Get a second opinion.
posted by cgg at 2:16 PM on November 22, 2007

Could be drugs, if you're taking any. Or were taking any. Legal or illegal, you should tell your doctor you did them.
posted by magacid at 2:38 PM on November 22, 2007

I have numbness on the left side of my face and often in my left arm (scary!), and it turned out that it was migraines -- specifically migraine with aura. On the first few occasions I didn't even really notice a headache, then over time they developed.

If your SO is female (i can't tell from your info), watch to see if the numbness happens right before her period - there's a dip in estrogen that was found to be the trigger for my symptoms. My doctors thought I had MS before finally figuring it out, so it might not be the first thing yours thought of either.
posted by ukdanae at 2:46 PM on November 22, 2007

My ex husband had Bell's Palsy and it took a long time to diagnosis it. I'd check into that. Good luck, let us know.
posted by wafaa at 2:46 PM on November 22, 2007

Did Bell's not even come up? That's probably the most common cause of facial numbness, though there is usually pain and limited motion as well. I think numbness is the first symptom, though.

Might be worth having a myofacial or dental surgeon take a look at the scans/your SO. Occasionally abnormal dental formations can cause nerve damage to the face, and I don't know that an MRI will show that very well.
posted by Lyn Never at 2:48 PM on November 22, 2007

Thirding Bell's Palsy, and also- any recent dental work requiring freezing? That can sometimes cause long-lasting facial paralysis.
posted by fish tick at 3:09 PM on November 22, 2007

I have Bell's Palsy right now with the exact same symptom...slight numbness in half of my face. Does she have any slight changes in her speech, a slight softening or slurring of her voice, slight difficulty swallowing? One of the main symptoms is flattening out of wrinkles between the eyebrows and smile lines as if you've had botox. Bell's doesn't always look as severe as the pictures you see on the Internet. I just feel like I've come from the dentist and the novocaine hasn't completely worn off. Also, mine was diagnosed due to the fact that I've had a terrible headache for three weeks that was initially treated as a migraine with extreme nausea. People who know me well can tell but otherwise you probably wouldn't notice anything.
posted by tamitang at 3:32 PM on November 22, 2007

Thanks all so far. To clarify question previously- yes female so good point regarding hormonal changes.

RE Bells Palsy- thanks for the links. She was asked if any exposure to ticks over the summer so guess from the Wiki article relating Bells to Lyme disease that ticks carry that may have been the way the docs and neuro guys were thinking.

We're in Czech and, while the health care system is in many ways excellent, the doctor's aren't the most communicative.

Regarding the Bells Palsy it seems to be a fairly wide ranging diagnosis ("a disease of exclusion") that can be caused by many things. What's your feeling tamitang and wafaa, and anyone else that has/had it of how useful a diagnosis this is at it seems from wiki that it's a case of 'you have this symptom, we can't pinpoint the cause, we call this Bells Palsy'.
posted by Gratishades at 3:57 PM on November 22, 2007

Yes, that's pretty much what the doctor said, "excluding everything else". I had an MRI (just in case, according to the doc) yesterday but with the holiday here in the US I won't get the results probably until Monday. The doctor was 99.99% sure it was Bell's Palsy but wanted the MRI just to be sure it wasn't an aneurism or some other dire thing. The other symptoms besides the numbness point to Bell's. Does your SO have the other symptoms I mentioned?

Evidently treatment is controversial, some advocating Valtrex or other antivirals, and steroids. Right now, I'm only taking pain meds for the headache since I've probably had this going on three weeks now, the antivirals probably wouldn't do much good according to the doc.
posted by tamitang at 4:53 PM on November 22, 2007

There is no controversy, tamitang. The antiviral treatment for Bell palsy is beneficial in the first 48 hours after onset. Thereafter it confers no benefit and exposes the patient to the risks of the medications.
posted by ikkyu2 at 5:05 PM on November 22, 2007 [1 favorite]

That explains why no medications for me then. Everyday the numbness seems a little different. Today it seems more settled in my mouth while yesterday and the day before it was more in my ear and cheek. More trouble swallowing and speaking today too. It is noticable enough that my son could tell on the telephone. But the headache is much better so maybe it's running its course.
posted by tamitang at 6:16 PM on November 22, 2007

Hmm. From what I've heard, Bell's Palsy often results from an interaction between a virus (most common are herpes, Epstein-Barr (mono), influenza, and Lyme disease) and facial nerves—said interaction occurs most often when triggered by a bodily stressor of some sort. See here and here.

(My father got Bell's Palsy in 2004. When he went into the hospital to have the partial facial paralysis/numbness diagnosed, it was discovered that his cholesterol was sky-high—and that he also had diabetes. It seems the oral herpes virus already existent in his body gained a foothold in the nerves when the body was stressed by the other conditions.)
posted by limeonaire at 7:04 PM on November 22, 2007

Some things I would consider having them do, just in general, to rule out/confirm some of the most likely possibilities:

1. Screen for herpes/Epstein-Barr/Lyme disease.

2. Get a biopsy of the lump (should do this regardless of the other symptoms). Also ask a question: Could the lump be physically impacting some nerve that's causing this?

3. If all other tests come up inconclusive/negative, consult an RSI/nerve specialist. Could be something related to laptop sitting posture. (Though really, this seems the least likely.)
posted by limeonaire at 7:09 PM on November 22, 2007

My sister experienced numbness on one side of her face as an adolescent and it turned out to be Bells Palsy. It lasted a couple of days and has never reoccurred--it's now 8 years later.
posted by HotPatatta at 12:16 AM on November 23, 2007

I had a similar experience in the Fall of 2001. Right side of my face had strange numbness. Had an MRI (with contrast), nothing was found. The only explanation I was given was that it was probably some kind of odd vascular headache, and it went away after several weeks. Since then, it has recurred about once a year, sometimes with headache and sometimes without. When I saw a neurologist in 2004, he agreed that it was probably a vascular headache, specifically cluster headaches, because of how the pain acted. And there was nothing he could do for me.

But no one ever mentioned Bell's Palsy. And when I mention it to any new doctor they tend to not think it is worth worrying about. Very tiresome.

I hope that you find a good answer from your doctors.
posted by monopas at 12:36 AM on November 23, 2007

Thanks all once again.

- the headache part of your symptoms weren't replicated. Hope the docs can clearly diagnose you. Sounds as though Bells is benign enough and eventually clears up.

limeonaire- thanks for suggestions- did occur to us that the lump could be having the impact but they seem to have ruled that out post tests.

monopas- sorry to hear that your syptoms recur, hope it dies down over time and the headaches aren't too debilitating.

Thanks once again all- I was wary or asking for medical advice on the internets and warned my SO that it could lead to wild and extreme speculations- thanks for proving me wrong.
posted by Gratishades at 2:15 AM on November 23, 2007

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