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Facial numbness and tingling
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Facial numbness and tingling

I am a 28 y/o W/F.  In April 2007 I was diagnosed with iritis three weeks after I was hit in the face after a canoeing accident.  I had one or two bruises on my face and a busted lip (no fractures or anything serious) immediately after but did not have unilateral eye pain, blurred vision and photophobia until three weeks later. My ophthalmologist gave me steroid eye drops and it was better after a few weeks.  It has returned three times (always the same eye - right) since and she repeated the steroid eye drops, which always helps.
Also about three years ago I was diagnosed with a small (I think 1.5cm) Syrinx at C6-7 after a car accident.  I have had right arm/hand radicular type of pain off and on since then. It comes on randomly and lasts anywhere from three weeks to maybe two months and finally goes away for several months.
About a month ago I started getting unilateral headaches, photophobia, eye pain, blurred vision and facial numbness/tingling all on the right side.  It was similar to iritis except for the addition of facial numbness and tingling.  The numbness/tingling in my face starts around the TMJ joint and goes to the corner of my lip, across my cheek and behind my eye to the medial corner of my eye. My PCP ordered a CT of the head which is normal.  I have anywhere from one to three of these a week.  They start at different times of the day and usually last until I fall asleep and wake up the next morning. My PCP said it could be migraines and said to return if it doesn’t get better or if any new symptoms develop.  On Tuesday I went to the dentist thinking I had an infected tooth, again on the right side.  The X-rays were normal and he even checked for TMJ and I have no popping or clicking in my jaw.  Now, since yesterday afternoon, I have started having the unilateral arm and hand pain as mentioned before.  I have Googled the facial paresthesias since it is the newest symptom (other than iritis and pain associated with the syrinx that I have had before) and it often says it is a symptom of MS.
Is it possible that the face numbness/tingling could be from the iritis, possible migraines or even the syrinx or would you look more into ruling out MS?
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Hi Carter,
How are you feeling?
I think face numbness and iritis are not related. It could be migraine, but this should be confirmed with help of two different neurologists.
Regarding MS, Multiple sclerosis is a chronic remitting disorder characterized by multiple white lesions in the CNS separated by time and location. The most frequent presenting symptom is unilateral weakness or ataxia. Headache is common, ill defined paresthesias are noted, Visual symptoms like diplopia, blurred vision are also present initially.
MRI is the neuro-imaging of choice, small plaques of 3- 4mm can be identified, particularly those located in brain stem and spinal cord.
MS can cause changes in sensation, muscle weakness, abnormal muscle spasms, or difficulty in moving; difficulties with coordination and balance; problems in speech or swallowing, visual problems, fatigue and acute or chronic pain syndromes, bladder and bowel difficulties, cognitive impairment, or depression.
The initial attacks are often transient, mild and self-limited. The most common initial symptoms reported are: changes in sensation in the arms, legs or face (33%), complete or partial vision loss (optic neuritis) (16%), weakness (13%), double vision (7%), unsteadiness when walking (5%), and balance problems (3%); but many rare initial symptoms have been reported such as aphasia or psychosis.
Your symptomatology as of now do not sound like you are having MS, but there are definitive guidelines, on which the diagnosis of Multiple Sclerosis is based. There are definitive lesions (suggestive of MS) on MRI also.
Once internationally accepted criteria’s are satisfied, then diagnosis of multiple Sclerosis can be made.
I think a repeat scan would be warranted to come closer to rule out MS.
Hope this helps.
Bye.
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