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Family Medicine  (Expert Forum)
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Bi-lateral Face Tingling
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD Boston - MA
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
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MedHelp Member's Question

Bi-lateral Face Tingling

by Jigger26, Sep 28, 2006 12:00AM
36 year old. Male. Excellent physical condition. I'm a runner do 60 plus miles weekly. All blood work done within last 2 months at time of yearly physical, all fine. I do suffer from some fairly strong anxiety issues. Mainly OCD. Let me get to the point. About six weeks ago I started having strange tingling sensations up the back of my scalp. They only last for a few seconds. They come and go depending on body position and stress. If I get the least bit anxious it happens. So we did an Mri in June. All was clear except for left maxillary mucosal thickening of the sinus.So, I attributed this to muscles and anxiety and still do. It is better but if I get an adrenaline rush it happens. I'll move on. About 4 weeks ago I started having bi-lateral tingling in my cheek areas and upper lip. My nose is also numb all over. If I lick the roof of my mouth with my tounge it reproduces the tingling. Cheeks, upper lip and nose. I have had a CT of the sinuses done within the last week, It still shows a left maxillary infection. So, I started antibiotics. I am in the medical field myself. I'M a Vet. My best friend is my physician and he seems to think that this is all anxiety related. I have developed a daily habit ofg teeth clinching. He and a local ENT agree that the bi-lateral tingling of the face is a result of this anxious habit. Have we missed anything. Can teeth clinching cause face tingling. I think it probably can as well as muscle tension, ect. I would love to clear this up and move on. I have an appointment with a Neuro in min November. Any Ideas. Thanks JeffC D.V.M.   P.S. Sore Jaws also.
Doctor's Answer

by Kevin Pho, MD, Sep 29, 2006 12:00AM
Anxiety can certainly be considered - but other etiologies can be considered before attributing it to this.  CT sinues and an MRI are reasonable initial tests.  



You can also consider imaging the carotid arteries looking for stenosis that can lead to strokes.  Checking other metabolic etiologies of neuropathy - B12 deficiency, diabetes and thyroid dysfunction - can also be considered.  



A referral to a neurologist can be considered for further evaluation.



If the workup continues to be negative, anxiety can be addressed.



These options can be discussed with your personal physician.



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Kevin, M.D.

kevinmd_
Member Comments (7)

by Jenny Wren, Sep 28, 2006 12:00AM
To: fulmer1
If you find out please post back.  I have the same feeling on my face, I describe mine as a tickling.  It started on the left side of my face about 6 years ago, now it has started a little on the right side.  Do you suffer from migraines?  I had a brain MRI in April, everything normal except radiologist noted, "EXTENSIVE sinus thickening", ethmoid and frontal sinuses, thought that was the answer, but after 3 weeks of 2000mg daily amoxicillin, its still there.  I'm going for a cervical MRI on Friday, I went to a pain specialist yesterday and received trigger point injections, she told me that muscle tension in the neck and shoulder area can cause the facial tingling.  I have been going to PT for 10 weeks now, they do the massage, elec stim, traction, heat and exercises, the facial tingling has really, really lessened, so this tells me that it has to with muscle tension.  I also suffer from extreme anxiety, but its so hard to believe that these feelings can be caused from muscles.  There is such a thing as muscular TMJ.

by Jigger26, Sep 28, 2006 12:00AM
I just got done running 8 miles and my problem temporarily left. I guess I loosen up. It is true that the sternocleomastoid muscle can mimic certain neurological processes. MD's will not agree. Anxiety and the internet are a bad team!!

by Jigger26, Sep 28, 2006 12:00AM
Sorry. I do not suffer migranes. Feels like feathers across maxillary nerves.

by Jenny Wren, Sep 28, 2006 12:00AM
To: fulmer1
Yes, feather feeling.  I read about that muscle, in fact the doc yesterday said that is the same muscle that she thinks is the cause of my problem.  I also read that restless leg syndrome can cause this, and it doesn't normally occur when the body is preoccupied, its at rest, it doesn't have to stop at just the legs.  Back a few months ago, there was a girl who posted on the mental health forum here, I think it was under "facial tingling caused by stress.  I have kept in touch with her by e-mail, shes from Nebraska, she flew to Arizona to see a well-known neurologist, and this is what he diagnosed her with. Yes, internet is bad, believe me I know.  You end up having MS, trigeminal neuralgia, Lyme disease, and lots of others.  I take a xanax (.25mg) and it really helps.  If I'm not wanting to feel sleepy, during the day I'll only take half.  Before bed a whole one.  Take care

by Jigger26, Sep 29, 2006 12:00AM
I am a doctor, of the animal realm. I think it is absolutely ridiculous that any one would suggest a stoke in an avid 36 year old runner. The numbness goes away when I run. My fasting glucose is 95 and my A1c is 5.1. Thanks for the great advice!!!!

by Jenny Wren, Sep 29, 2006 12:00AM
To: fulmer1
I think you should try to post on the doctor-patient neurology forum.  I have posted 4 different times, I didn't know at the time of the 4th one that there was a limit of 2 questions in a 6 month period.  Maybe check out what the doc said there.  I know how frustrating it must be, I never experienced numbness though, I would be freakin at that.  My next step is possibly looking into Lyme.  I live in PA and its become an epidemic here.  Hope you get some answers soon!!!

by kthysvz, Jan 04, 2007 12:00AM
I am having right side facial and head tingling. I have had this for about 9 years and have had ct and mri and all neg. I have it all of the time and worsen when I am tired or anxious. Somedays it is just mainly around my right eye and somedays it is all of the way to lip. It is also arounf my right side of my head, Now, I just started experiencing a new pain. I woke up with a stiff neck about a month ago and even though I can move my neck now the ball or socket that at the right side of where your head goes into your neck is always tender. I went to the dr and he said that it is not a swollen lymp node and that he just thought that is was inflammed. Well one month later and it is still like that. So being all of this is happening on my right side only I was just wondering if anyone else had any comments. Someday it feel like someone is taking a rope and pulling it across the top of my nose. Somedays I have a feeling that I might have washed my face with a bar soap and it has that tighness feeling like when you do not get all of the soap off. The only other pain