Brief Answer:
Bilateral crawling feeling of the face

Detailed Answer:
Good evening and thank you for your question on this network.

I'm very sorry you're not feeling well and would like to point a couple of things about the symptoms you are referring in order to try and determine what could be the source of the problems you're facing.

In order to check to be sure that nothing in the brain were causing your symptoms I would order an MRI in order to look for what could be referred to as a diffuse process within the cerebral hemispheres and especially in the deep white matter. Alternatively, I would also check the area of the brain stem where the trigeminal nerves originate to be certain no pathology is causing a compression or other irritative effect. However, the chances of either one of these types of processes being present in the brain without there being any other symptom other than tingling in the face is extremely remote.

I would also check your blood for factors such as thyroid hormones, Vitamin D, D2, D3, B12, folic acid, and perhaps an ANA profile and ESR looking for evidence of anything that could cause an inflammatory reaction giving you these symptoms. Again, the probability that any type of chemical or electrolyte imbalance or disturbance could be the sole cause of these particular symptoms is unlikely since one would expect more than just the face and head to be affected.

With other workups being done involving the heart my index of suspicion for anything purely organic involving either the brain, heart, or chemistries of the body is extremely low.

You did not mention what the source of the problem was several years ago when you experienced the same symptoms. My assumption is that your symptoms eventually resolved and it wouldn't XXXXXXX me if you were to tell me that they went away spontaneously in a similar fashion to how the symptoms may have come on.

I might make one other suggestion since you did mention that you have migraine headaches. There is a well recognized type of headache called ATYPICAL MIGRAINE. Very contrary to what even most doctors believe to be the definition of such a headache...in fact, ATYPICAL MIGRAINE HEADACHES do not always present with actual headaches. Let me repeat that statement. ATYPICAL MIGRAINE HEADACHES (or migraine equivalents/migraine variants) do not always present with actual headaches. Imagine that for a second....a headache type that doesn't necessarily have a headache as part of its manifestation. Strange huh? What they do present with, however, are symptoms such as numbness, tingling, internal sensations that cannot be easily described but which clearly feel, odd sensory perceptions, visual aura or phenomenon, GI upset, malaise, fatigue, and even apathy.

Look at this article for more detail on what I just presented to you:

http://emedicine.medscape.com/article/0000-overview

And so where many doctors might see any of these symptoms as indicative of a psychiatric disturbance or exacerbation of some psychological condition such as mood disorder, depression, anxiety, PTSD, etc. I, as a headache specialist and neurologist could look at these symptoms as being potentially indicative of an ATYPICAL MIGRAINE or MIGRAINE EQUIVALENT with or without headache.

What I always ask my patients to do is to keep a careful diary and log of symptoms that come and go even if no headache were to accompany and we always review all of their documentation in case it starts to become clear to me that the patient is suffering from something as off the beaten trail as a MIGRAINE EQUIVALENT.

I would therefore, say that if you have gone through the blood testing, the imaging of the head, and feel that everything is in order......search down a NEUROLOGIST/HEADACHE SPECIALIST....such as myself......and schedule to see them in their offices in order to assess what you've got as very possibly one of these rarely diagnosed headache entities.

If I've adequately answered your questions could you do me a huge favor by CLOSING THE QUERY and being sure to include some fine words of feedback along with a 5 STAR rating if you feel my suggestions have helped? Again, many thanks for posing your questions and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 80 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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Brief Answer:
Chance that this is cardiological- small.....very small....I agree BUT---

Detailed Answer:
I agree that the type of symptom you are referring in your face is LESS likely a phenomenon of the heart or cardiovascular system than something else such as neurological, metabolic, or stress/anxiety driven (recall you had this once before). However, if you were my patient I would do at least an initial screen of the heart with a simple EKG and then, looking for possible vascular compromise at the level of the carotid arteries.

My recommendation for neurological workup would be that of an MRI of the brain AND cervical spinal cord. I would include gadolinium contrast in the event that lesions existed that could be better seen with enhancing XXXXXXX as tumor, MS or sarcoidosis. I don't think the likelihood of any of those disorders is great given the limited information you've provided but this recommendation covers virtually all those bases.

I already gave you what I would consider as a metabolic/chemistry screen in blood above so won't repeat that here.

At this point if there are no other comments then, CLOSING THE QUERY with a bit of positive feedback and even a 5 STAR rating if you feel my suggestions have helped would be truly appreciated? Again, many thanks for posing your questions and please let me know how things turn out.

Do not forget to let me know what your GP says and if they have consented to send you to a specialist by writing back to: www.bit.ly/drdariushsaghafi

This query has utilized a total of 93 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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Brief Answer:
Thank you for the update

Detailed Answer:
I concur with the now even greater probability that your symptoms are either neurological, metabolic, or non-neurological which would then, probably lead down the road of stress/anxiety.

But first I would still recommend having a neurological set of tests and examination done as I stated. Do keep in mind that blood pressures should be checked in different positions to know that they are truly "OK"....a neurologist will know best about this sort of thing as related to possible lightheadedness.

I think that sinus problems are the least likely organic problem that could be causing your symptoms.

Once again, CLOSING THE QUERY with words of positive feedback and a 5 STAR rating for the suggestions given would be very much appreciated? Please let me know how things turn out by writing back to: www.bit.ly/drdariushsaghafi

This query has utilized a total of 108 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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