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Facial Tingling with Bulging C6-C7?
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Facial Tingling with Bulging C6-C7?

I had a cervial MRI and was told I have a bulging disc at C6-C7, which, to me, potentially explains the tingling in my arms and hands.  However, I also get tingling in the face quite often, and the occassional numbness in the chin.  When I do, I often realize that my neck is in a position where my chin is on my chest (looking at my feet), but not all the time.  Sometimes it just happens.  Can C6-C7 be responsible for the facial tingling?  (I don't take any meds).
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First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
    A bulging disc a C6-C7 is most likely to compress the nerve roots as they exit the spinal column and can cause a range of symptoms (dpending on the severity) which include pain, muscle weakness and atrophy in the muscles affected or numbness and tingling.  In the most mild cases the the numbness and tingling is intermitent and not bothersome.  In the worst cases it can lead to permanent loss of the ability to use that arm.  The muscles supplied by the nerve roots C6 (biceps, brachialis, etc) and C7 (triceps, etc) are all in the arm, and they also provide cutaneous sensation (sense of touch to the skin) of the lateral aspect of the arm.  I cannot explain facial numbness based on a C6-7 disc.  However the symptom of feeling numbness when you flex your spine (placing your chin on your chest) is called l'hermittes sign and although non-specific can some times indicate a demyelinating lesion in the spine (as are found with multiple sclerosis).  Given your symptoms I would suggest an MRI of your brain with contrast and a repeat MRI of your C-spine (only if it was not done with contrast the first time)- to evaluate for any signs of multiple sclerosis (MS).  
I hope this has been helpful.
15 Comments
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Avatar_n_tn
Hi,
   Would you be able to describe the neck and chin issue..turning involuntarely?
   Are above 50 yrs? are you overweight?

   Bob
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First of all, simkiss, I can relate to the tingling face.  I have had this going on for 6 years now, just this past Fall I finally had a c-spine MRI done, it showed a bulging disk at C-3, C-4, of course being mine is higher than yours, I don't have arm and hand symptoms, just the burning pain that extends from my shoulder to the back part of my skull, when I have a really bad day, I can feel the stiffness and pain in my neck muscles from my shoulder up to my ear, then that is when I get the facial tingling, it only lasts for a few seconds, then gone.  It is definently aggravated by neck movement, and by lifting my left arm up to touch the back of my neck/head, it does it every time.  I also have had 2 brain MRIs w/ and w/o contrast, everything is normal there.  I hope you feel better.

BobbHilton, you seem very intelligent, is it possible to have this tingling with cervical issues? I wrote to the neuro here before, and he said "NO".  There are so many people that I read about that have this and the only thing that is found is a bulging or herniated disk.  I also have no neck curvature.  Thanks so much!!
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Avatar_n_tn
Thanks for the complemnt, but I'm a retierd Neurologist (not a very intelligent)
I post here and few other sites.
    The answer to your Q could be both ways (yes and no)!!
If you are talking anatomically , then its a big yes since the 5th cranial nerve (the sensory nerve of the face and part of the scalp) has 3 sensory nuclei (centers) one of them extends to C3 (some books say C4)
but it lies in the posterior part of the cord (not affected by an anterior compression of a disc) if got damaged it may cause sensory changes pain in the outer side part of the face (not central , not around the mouth) I mean the outside part of the forehead, cheek, or the jaw (we call it Onion skin pattern)...but why we could say no to your case , because the fibers carying the sensation of the other half of the body are very close and they would be mostly  affected in any possible damage.
    Having said that, there are few non neurological journals published about the phenomenon of concurrent pain in craniofacial and cervical structures, and clinical reports and opinions are presented regarding theories of cervical-to-craniofacial and craniofacial-to-cervical pain referral...but in my openion they still need a long way to prove that

   Bob
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Avatar_f_tn
Thanks for the help, are you saying that if the C-3 was the cause of my symptoms that I would have it on both sides of my face?  Because for the longest time it was just on the left side, now it has started on the right.  Its not like a a falling asleep tingling, more like a hair on my face, or a short little buzz sensation, almost like you should hear the buzz on the outside when it does it.  LOL.  The MRI results says:  At C-3, C-4, there is a bulging disc to the left of the midline producing effacement of the ventral subarachnoid CSF space.  No cord impingement.  Straightening of the cervical lordotic curve.  Is this in your opinion, a reason for the facial feelings?  You talk about the middle portion, mine is in the maxillary sinus area, but when my neck is hurting badly, my left ear will hurt.  When this first started I had been to 4 ENT docs, they all told me that my ears are fine.  Could this problem with the ear be connected with the neck problem? All this started about 2 months after I was rear-ended, the migraines first, then 2 years later the weird facial feelings, this crazy stuff with my face really drives me crazy.  Thank god I never had numbness.  What about MS in your opinion?  Or Lyme?  Thanks very much for your time and help!!!  Jen
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Avatar_f_tn
Hi there, forgot to also add that I do suffer from migraines, my GP thinks that the facial feelings are migraine related.  My mother, maternal grandfather, have had migraines all there lives, I just started having them 8 years ago, now my son who just turned 11 is starting to have them.  Thanks
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Hi Bob,

I'm 32 and overweight.  6'0" and 230, but athletic build; meaning my ideal weight is 190 (rather than 175).  As for the neck issue, I often feel it then realize my chin is in my chest while I'm looking straight down, or turning and looking down at an angle.  I used to be a requent neck-cracker but have cut back significantly.  When I get the facial tingling, it happens both randomly and in conjunction with neck position mentioned above.  I get the following for 2-5 seconds at a time, maybe a dozen times a day...

Lips: tingling, center
Chin: slight numbness like long after novicane wears off at the dentist
Eyes: pins and needles in right eye, but left eye too every so often
Cheeks: mostly right cheek tingle or burn, but occasional left cheek too
Nose: sometime feels numb-like where the sinuses are and glasses rest
Tongue: occasional tingle in front
Scalp: top left skin-level headache from time to time.

When I wear a soft neck brace, it seems to either alleviate or prevent a good deal of the paresthesias.  Also, the symptoms progress as the day wears on.  Then when I lay down I night, I feel good all through the night, and refreshed when I wake up.

For my local symptoms themselves, my entire spine feels out of whack.  I have constant soreness from C4 down to T5.  Also from about C8 to T5 it feels like it's a burning feeling that also covers the shoulder blades.  In addition, I have pain from L1 down to S2 and corresponding sciatica-like symptoms in my legs.  Additionally, each morning, I wake up with the soles of my feet tingling a little but once I step on them, it goes away in an instant.  The S1/S2 pain hurts worst behind my knees where it often feels like pulled hamstrings, but I know they're not pulled.  I do get burning in my calves front and back as well.  

What a mess!  :o)  I think I need a new spine.  I saw the doc yesterday and he prescribed a traction machine for my neck seeing as that the neckbrace seems to help.  I also see the neuro on thursday for the first time.  

Any input is appreciated and I know diagnosis in a forum is impossible, but the more heads the better if you ask me.

Thank YOU.
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Avatar_n_tn
Hi,
Thanks for the help, are you saying that if the C-3 was the cause of my symptoms that I would have it on both sides of my face? yes (some books say even C4)
(Because for the longest time it was just on the left side, now it has started on the right. Its not like a a falling asleep tingling, more like a hair on my face, or a short little buzz sensation, almost like you should hear the buzz on the outside when it does it. LOL.)  Tingling is more reliable because it indicates an acute irritation of a nerve while numbness indicate a chronic process

The MRI results says: At C-3, C-4, there is a bulging disc to the left of the midline producing effacement of the ventral subarachnoid CSF space. No cord impingement. Straightening of the cervical lordotic curve. Is this in your opinion, a reason for the facial feelings?  a surgical decision can not be, under any condition,  be taken on line ..you need a full team approach of a neurologist, neuroradiologist , and a neurosurgeon  . if the team see any compression or distortion from the lordosis causing an irritation of the cord then the correction could help you

You talk about the middle portion, mine is in the maxillary sinus area, but when my neck is hurting badly, my left ear will hurt. When this first started I had been to 4 ENT docs, they all told me that my ears are fine. Could this problem with the ear be connected with the neck problem?
About the phenomenon of concurrent pain in craniofacial and cervical structures, clinical reports and opinions are presented regarding theories of cervical-to-craniofacial and craniofacial-to-cervical pain referral.

What about MS in your opinion? Or Lyme? The MRI and the serology blood test could answer that

   Sorry for using this way of answering , because so many other posted more questions....

   Bob
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Avatar_n_tn
I know for me, my brain scan MRI was completely normal.  My Lyme test was negative.
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Avatar_n_tn
Hi
   My apology if I used the telegraphic way of answering, because I'm very slow in typing (never typed in my life), and so many questiones sent to me

   (I often feel it then realize my chin is in my chest while I'm looking straight down, or turning and looking down at an angle. I used to be a requent neck-cracker but have cut back significantly. When I get the facial tingling, it happens both randomly and in conjunction with neck position mentioned above. I get the following for 2-5 seconds at a time, maybe a dozen times a day)
  
   You are describing a cervical dystonia, it could happen due to issues of the
1-(FM) formina Magnum (the hole connects the skull to the spinal canal),
2- Cranio-cervical junction (the bony junction between the skull and cervical vertebra) inflamation (inflammation), early sublaxation, rather than a disc
3-using neuroloeptics.
4-But in your age group (much younger than the age of Ideopathic cervical dystonia) you  have Wilson diseas ruled out by a neurologist


(Lips: tingling, center,Chin: slight numbness like long after novicane wears off at the dentist, Eyes: pins and needles in right eye, but left eye too every so often, Cheeks: mostly right cheek tingle or burn, but occasional left cheek too
Nose: sometime feels numb-like where the sinuses are and glasses rest, Tongue: occasional tingle in front, Scalp: top left skin-level headache from time to time).
All these symptomes are short lasting and mostlikely non specific, but a transient or an intermittent irritation of the cervical spine especially the upper 4 segments by any thing like a bony overgrowth, a lesion in FM  could give you that, but you said you had a normal MRI!

(When I wear a soft neck brace, it seems to either alleviate or prevent a good deal of the paresthesias. Also, the symptoms progress as the day wears on. Then when I lay down I night, I feel good all through the night, and refreshed when I wake up).
Dystonias generally improved by rest and worsoned by stress /fatigue. If the neck brace is helping then its acting as a SENSORY TRICK (a medical term used for things improving the dystonia like touching you chin could prevent the turning of the nek...try to google it)

(For my local symptoms themselves, my entire spine feels out of whack. I have constant soreness from C4 down to T5. Also from about C8 to T5 it feels like it's a burning feeling that also covers the shoulder blades. In addition, I have pain from L1 down to S2 and corresponding sciatica-like symptoms in my legs. Additionally, each morning, I wake up with the soles of my feet tingling a little but once I step on them, it goes away in an instant. The S1/S2 pain hurts worst behind my knees where it often feels like pulled hamstrings, but I know they're not pulled. I do get burning in my calves front and back as well).

If the C6-7 bulge is central then it may give stiffness of the feet , while the othe symptomes are unlikely..so the Neurological examination will tell if you need MRI of your LS spine, and/or EMG/NCS (a nerve study which you will need in the upper limbs to see any nerve irritation from the cervical disc!) then on top of the routine blood test its wort doing Vitamine B 12 level and thyroid function test

What a mess! :o) I think I need a new spine? me too and new eyes.

Can C6-C7 be responsible for the facial tingling? No.

  Bob
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Avatar_f_tn
Thanks for the input, the way you answered was just fine, your thoughts are greatly appreciated.  I was tested for Lyme, but heard that the ELISA test is very inaccurate. It was normal.  As far as the curvature issues, is that pretty common in the general population?  And what causes this?  

I have also been tested for Lupus, RA, sed rate, thyroid, hormone levels (FSH), IPEP/SPEP, anticardio (something), and EBV.   The neuro put me on Metanx, which is a B-6, B-12 supplement, this really helped alot for a short while, but after taking it for a while, the stupid feelings came back.

Have you ever heard of a neural scan?  I had this done on my face and they said that there was no evidence of nerve damage.

Lastly, can sinus/allergie problems cause this?  When I had my brain MRI done last year, everything was normal except for "EXTENSIVE" sinus mucomembranous thickening involving the ethmoid and frontal sinuses.

Lastly, Bob, I think that its so nice that you take the time to help others that are having such a hard time.  Thanks again, Jennifer
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Avatar_n_tn
Thanks, Bob!  I appreciate you taking the time!  very, very much.
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Avatar_n_tn
Not at all, a couple of hours a day is not much to share this with you

Jennifer,
I was tested for Lyme, but heard that the ELISA test is very inaccurate. It was normal.
most major centers dealing with Lyme disease say " seronegative Lyme disease is uncommon" but Increased specificity (the possibilty of a correct negative result) could be obtained using Western blots. though most centers use it only for a weak positive ELISA  

As far as the curvature issues, is that pretty common in the general population? And what causes this?
A physiatrist would be better answering about an inreased cervical lordosis, because we deal/ talk about the lumbar one and all I know from the old days when  a plain  X-rays of the cervical spine was the only thing in ER to evaluate a patient  with acute soft disc rupture!! may be normal, or may show straightening of the usual lordosis as a result of paraspinal spasm..unless a patient is presenting with extrapyramedial signs which is not in your case ..not to forget that laminectomies (a kind of neck surgery) carry a late risk of reversed lordosis, or "swan neck deformity," due to laxity of the posterior supporting elements.

I have also been tested for Lupus, RA, sed rate, thyroid, hormone levels (FSH), IPEP/SPEP, anticardioLIPIN (something), and EBV. The neuro put me on Metanx, which is a B-6, B-12 supplement, this really helped alot for a short while, but after taking it for a while, the stupid feelings came back.

Vitamine B6 in excess may cause a spine and nerve irritation

Have you ever heard of a neural scan? Never
I had this done on my face and they said that there was no evidence of nerve damage???? getting old is some thing I can't avoid but I keep sure I'm  never old to mis/follow up with a new thing like this...do you have more information about it?

Lastly, can sinus/allergie problems cause this? When I had my brain MRI done last year, everything was normal except for "EXTENSIVE" sinus mucomembranous thickening involving the ethmoid and frontal sinuses.
In Medicine, very thing is possible until proven other wise ,so, the best way is to treat it and resolve the membrane thickness and see

    Bob
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Avatar_f_tn
Thanks Bobb, I seriously think that the Metanx made it worse, so I stopped it all together.  As far as the neural scan, my neuro told me that this is a waste of money, just something that the pain center can get away with billing the insurance company for.  It works like an NCS/EMG, but no needles.  They use a wand, that resembles a pen and they run it across your face where the nerve distribution is .  Its painless.  I found it on the web, and even saved it on my favorites, but can't locate the website.  Maybe try "neural scan ".  Thank you for your time, you have been very helpful.  I will try not to bug you anymore, LOL.  God bless and take care, Jennifer
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Avatar_n_tn
I have numbness in my face and hands that started when I herniated a disk in my neck. I actually felt the disk tear and the next day my face and hands were numb. This happened over a year ago and I am still having numbness. My herniated disk is at c4-c5 level. All the doctors tell me it can't cause numbness in my face and both hands but I know it does. I was perfectly fine until the injury. I have been tested for everything and the only thing they can find is the herniated disk. When I lay down the numbness subsides, when I sit up it comes back. Makes since to me. When I am upright there is more pressure on the disk causing it to bulge more. I also have other symptoms from it. Tones in my head, headache, dizziness, aching pain in both arms. I take advil all the time. It helps some, I tried not taking it but I have a sharp pain go down my right arm and into two fingers. Now if I could just figure out how to fix the herniated disk I would be so happy.
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A related discussion, Burning and Tingling hands, face, scalp was started.
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A related discussion, Can sinus problems cause pinched nerves? was started.
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