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Facial Numbness & Muscle Twitching
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Facial Numbness & Muscle Twitching

Almost 2 years ago I had sudden onset of bilateral facial numbess, I went to the hospital & was admitted for 3 days..since then I havent been the same. I had jaw spams while in the hospital, but over time it has now spread throughout my whole body. I have chronic fatigue, weakness, dizzines, achy pain all over,and numbness in hands,arms,legs,feet & still in face. My muscle twitching gets worse upon exertion or when I am extermly tired.Each "spell" lasting anywhere from a few seconds to as long as 30 minutes (off & on repeatdly one right after another). I feel tired and drained after the twitching has stopped. My resting pulse has been between 108-120,but as high as 150 over the past year or so. I have had multiple MRIs & CT of my brain..it shows I have a small infarction in the thalamus region on the left side about 10mm in size. Results show it was old and not current. Could it be causing my symptoms now though? I have had mulitple blood labs drawn, everything comes back normal. EEG & EMG both came back normal. I don't feel real and havent since the day my face went numb. My symptoms seem to be "okay" but I come "crashing down" at anytime. I am at a loss of where to go to next, I have seen multiple doctors & no one can seem to figure out what is wrong. Where do I go next?
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Hi there. You need an urgent neurological check for these muscle twitching or tremors. There are certain causes responsible for muscle twitching like diet deficiency, drug overdose, and side effects of diuretics, corticosteroids, estrogens, exercise, benign twitches, and nervous system conditions like amyotrophic lateral sclerosis or ALS, muscle dystrophy, spinal muscular atrophy and myopathy. Your neurologist needs to look into these conditions one by one. The other possible cause could be multiple sclerosis and is a diagnosis of exclusion. The symptoms of multiple sclerosis are loss of balance, muscle spasms, numbness in any area, problems with walking and coordination, tremors in one or more arms and legs. Bowel and bladder symptoms include frequency of micturition, urine leakage, eye symptoms like double vision uncontrollable rapid eye movements, facial pain, painful muscle spasms, tingling, burning in arms or legs, depression, dizziness, hearing loss, fatigue etc. The treatment is essentially limited to symptomatic therapy so the course of action would not change much whether MS has been diagnosed or not. Apart from clinical neurological examination, MRI shows MS as paler areas of demyelination, two different episodes of demyelination separated by one month in at least two different brain locations. Spinal tap is done and CSF electrophoresis reveals oligoclonal bands suggestive of immune activity, which is suggestive but not diagnostic of MS. Demyelinating neurons, transmit nerve signals slower than non-demyelinated ones and can be detected with EP tests. These are visual evoked potentials, brain stem auditory evoked response, and somatosensory evoked potential. Slower nerve responses in any one of these is not confirmatory of MS but can be used to complement diagnosis along with a neurological examination, medical history and an MRI in addition, a spinal tap. Therefore, it would be prudent to consult your neurologist with these concerns. Take care


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