Suggest Treatment For Intermittent Tingling Feeling On Face

Posted on Mon, 3 Nov 2014

Question: About a month ago I begin having tingling on the right side of my face. It would come and go. I would have it every day, but usually came on as the day progressed. I never woke up with it. It usually came on later in the morning or afternoon. It also rarely is there when I am in bed before going to sleep. It is usually tingling/numbness feeling, but I can still move my face. Its more like its on the surface of the skin. I had a CT scan and blood work and everything came back normal. My biggest fear is a tumor. I do not have headaches or other symptoms. I do have hypothyroidism and according to my last lab work, I am still a bit hypothyroid, so I do feel like I am in a fog most days as I wait for my Synthroid to adjust. Somedays the tingling is very pronounced from my upper jaw to my ear and up to my eye. I have experienced a floater here and there. My doctor has suggested compression of the trimengal nerve, but I don't have pain. I do suffer from anxiety. She did say that if things got worse she would order more imaging studies. Nothing has really progressed. Somedays its ok and other days its very frustrating. What are your thoughts? What are the chances of a CT scan missing something major?

Answered by Dr. Ravi Soni (52 minutes later)

Brief Answer:
There are many possibilities for these symptoms

Detailed Answer:
Hi, Thanks for your query. I have read it thoroughly and I shall answer it accordingly.

With these symptoms the differentials can be:
1. Compression of trigeminal nerve
2. Vitamin B12 deficiency
3. Any kind of neuropathy [this could be diabetic or any other neurological illness]
4. Migraine
5. Fracture in facial bones
6. Menopause
7. anxiety symptoms
8. Space occupying lesion in the brain that causes compression on the nerve
9. cerebrovascular accidents [stroke, TIAs]

Here your CT SCAN HEAD came to be normal but it can miss the small soft tissue lesion less than 1 cm. SO you can discuss about MRI brain with your doctor.

Here, migraine, fracture of facial bones are ruled out.

Do you have irregular periods? signs of menopause because your age is approaching towards it. Do these symptom get worsened during or before your periods?

Do you have anxiety symptoms like nausea, dizziness, racing heart beat, confused feeling, excessive sweating, heaviness over head, breathing difficulty, feeling that you might go crazy etc.

Did blood work include Vitamin B12 abd D3 levels? If yes then give me the results.

You said you have floaters but when? do you have any other symptoms associated with that? like headache, photophobia, phonophobia, lightening sensation in vision, nausea, vomiting etc.

There are possibilities of minor tumors in the brain region which is compressing the nerves supplying the face. But if has increased to such an extent that it compresses than it must have been detected in CT SCAN.

Whether these symptoms get worsened with stress ot excessive thinking?

I am waiting for your answers. Give answers accordingly for each questions. I am in favor of MRI brain to be done. Discuss this with your doctor. Wishing you good health.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Ravi Soni (12 minutes later)

B12 and d3 were both normal my doctor said. My periods are regular. I do get dizzy and nauseated with stress. Inalso do have anxiety but never experienced this before. Today my tingling is not there but my eye on that side feels swollen but isnt

Answered by Dr. Ravi Soni (31 minutes later)

Brief Answer:
I shall go with nerve compression

Detailed Answer:
Hi, Thanks for writing again and for the answers.

So, Many possibilities have been ruled out with your answers. Vitamin deficiency, menopause, stroke and TIAs.

The remaining possibilities are anxiety symptoms, intra cranial tumor, compression of the nerves, various neuralgia occurring in face and ear region.

Discuss this all with your doctor and go for further imaging studies, also go for nerve conduction studies for nerves in face particular trigeminal nerve.

I have tried my best to help you. Anxiety can be the cause but here it can be diagnosed by excluding the other conditions.

Wishing you good health.

Above answer was peer-reviewed by : Dr. Shanthi.E