Facial tingling, normal brain MRI, what next?

[Jenny Wren]

I am a 35 year old female, 8 years ago, after a minor car accicent, I started having left sided, burning and throbbing type headaches. 2 years after the headaches started, which was only there on occasions at that time, I started feeling a weird tickly, kinda bug crawling sensation on the left side of my cheek.  As the years have gone by, I have linked these headaches to my period, or ovulation, but now I have been experiencing ear pain, like a tightness in my jaw area, along with ear pain.  When I feel the tighness in the jaw area, the weird crawling sensation starts in my face and lasts just for a few seconds then leaves.  This feeling is aggravated by neck movement or stretching my arms over my head.  I started physical therapy about 7 weeks ago, at first the feeling have subsided, but in the last week or so, the facial feelings have turned into more of a tingling, I'm really worried.  I had a brain MRI w/ contrast back in April of this year, only thing that was found was sinus thickening.  My shoulders hurt, my neck, and my ear almost on a daily basis, and whats really weird is that when I wear a tight shirt it feels like bugs crawling under it, and stops when I remove my shirt.  What could cause these feelings?  I'm scared its MS, But was told my my doc that after 8 years of these symptoms, it would have shown on a MRI?  Do you think so?  Could these strange feelings under my shirt be caused by muscle tension?  Would these feelings happen even without clothing on if it was MS?  I have no numbness, no weakness, vision fine, love hot baths.  Thanks so much, I'm worried!!

[CCF-Neuro-M.D.-SH]

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.
    The symptoms you describe are most consistent with cervicogenic(from the neck) migraine headaches.  When the neck is injured it can cause irritation to the peripheral nerves in the cervical region.  These nerves are thought to precipitate migraine headache through increased central sensitization. Neck problems can also lead to ear pain and dizziness as well.  The jaw tightness/pain may be TMJ disorder and could be evaluated by your dentist for a possible bite guard.  Patients with migraine headaches have "increased central sensitization", which means that minor stimuli that would not affect another person(such as a tight shirt) can be percieved by the migraine sufferer's as strange feelings, pain or tingling.  
   As far as MS is concerned, one would expect your MRI to be positive after this length of time, but there are some forms of MS that involve primarily the cervical spine, and/or the lesions were minor and healed/were not detected.  To complete your MS workup and for the issue of cervicogenic migraines, I would recommend an MRI of your cervical spine with contrast.  If you are still uncertain a lumbar puncture looking for inflammation may also be done.
   I would recommend that you start a migraine preventative medication such as elavil once daily, and a muscle relaxor such as parafon forte in combination with physical therapy of the neck by a therapist that understands cervicogenic migraines.
I hope this has been helpful.

[jody1969]

hi there. i dont have any words of wisdom here, but ive been experiencing the tingling also. ill get little patches of it on my face (diff places nose, cheek, lips, etc) and my feet too. im thinking maybe MS too, but i cant afford to go to the dr. now. but the worrying about it is driving me insane :(  im curious as to what the dr. repies. i have GAD w/ panic disorder and just recently started therapy, and i can tell you anxiety can cause all kinds of symptoms, so if everything else has been ruled out then maybe thats what it is, but im no dr. i kinda wondered about lyme disease too. have they checked you for that? il check back soon. take care and good luck to you:)

[jody1969]

i live in Va. we've been camping alot every summer for the last four yrs. though i have not found a tick on me, who knows. i read alot about lyme on this forum and i have some of the symptoms. i could only wish it were lyme, b/c thats atleast curable :/  i thought i had a stroke (im 36) about a month and a half ago. i actually posted on here.  i woke up in a state of panic thought i had diabetes (just b/c my b/f was just diagnosed i guess) and i freaked out. then he tested my sugar it was fine. so then i really started panicking thinking something was really wrong w/ me. then i started hyperventilating, getting tingling in my left hand and arm. then it went to my leg, foot and later that day cheek. i was panicked all day thinking i was in the middle of a stroke, but too scared to go to ER. i was coherant all that, vision fine, no weakness, but it went away after about 10 hrs. i calmed down some. who knows

[jody1969]

i live in Va. we've been camping alot every summer for the last four yrs. though i have not found a tick on me, who knows. i read alot about lyme on this forum and i have some of the symptoms. i could only wish it were lyme, b/c thats atleast curable :/  i thought i had a stroke (im 36) about a month and a half ago. i actually posted on here.  i woke up in a state of panic thought i had diabetes (just b/c my b/f was just diagnosed i guess) and i freaked out. then he tested my sugar it was fine. so then i really started panicking thinking something was really wrong w/ me. then i started hyperventilating, getting tingling in my left hand and arm. then it went to my leg, foot and later that day cheek. i was panicked all day thinking i was in the middle of a stroke, but too scared to go to ER. i was coherant all that, vision fine, no weakness, but it went away after about 10 hrs. i calmed down some. who knows

[jody1969]

i live in Va. we've been camping alot every summer for the last four yrs. though i have not found a tick on me, who knows. i read alot about lyme on this forum and i have some of the symptoms. i could only wish it were lyme, b/c thats atleast curable :/  i thought i had a stroke (im 36) about a month and a half ago. i actually posted on here.  i woke up in a state of panic thought i had diabetes (just b/c my b/f was just diagnosed i guess) and i freaked out. then he tested my sugar it was fine. so then i really started panicking thinking something was really wrong w/ me. then i started hyperventilating, getting tingling in my left hand and arm. then it went to my leg, foot and later that day cheek. i was panicked all day thinking i was in the middle of a stroke, but too scared to go to ER. i was coherant all that, vision fine, no weakness, but it went away after about 10 hrs. i calmed down some. who knows it may have been one im not sure. but ever since then, ihave been getting tingling here and there. like my face, my right foot more than my left, sometimes behind my left shoulder blade. who knows, i pray ALOT, and i believe God will help me through this if it is physical and not mental. i get lightheaded sometimes too. do you?  i also get headaches. not nearly like i did after that episode though. i posted about one headache i got like a week before that episode, and the dr said it sounded like a migraine w/ an aura. ive had those types like 3 times my whole life. but im thinking these other ones are tension headaches, cuz my neck aches too. im sorry for rambling. its just i dont read too much about other peeps w/ facial tingling. its nice to have someone to relate too :) take care ill be back:)

[jody1969]

he hit enter button cpl times sorry

[zzzzzzzzzz]

Hey Jenny - Great that you managed to get your question posted! - I am sooooo jellous - have tried nearly every day for over 6 months! I am asleep when they get posted - every morning there are always 2 more there even though they say it is set at a different time each day. Anyway - enough grumbling sheila !!!! As I say - glad you got yours on anyway.
Interesting you say things are worse around your period - I often find this also - have read that high eostrogen/low progesterone lvels can cause all sorts of crazy problems - even read claims of MS reversal through use of progesterone cream - I must say I have my doubts, but one has to keep an open mind about these things - asked Doc for hormone tests and she refused! said I just had to accept things and wrote out a script for a drug from hell thats supposed to prevent migraine and actually turned me into a zombie (sandomigran its called - avoid at all costs - neuro said he never prescribes it) Anyway, I'm going to get hormones checked privately as so many people have been on at me about it, and they're starting to hassle me cos I have'nt done anything about it yet. It'll be intresting to see if they are indeed a problem.
Better get to work - take care xxx

[SteveIT]

See what the doc says, but for what it's worth:

You sound like you have muscular TMJ. Ear pain, jaw tightness, and so on can be caused by spasming jaw muscles, especially the masseter and the pteregoids, while your neck and body sx could be caused by tight neck muscles, including SCMS, traps and scalenes, which tend to refer pain and odd sensations downwards, below your neck. TMJ sufferers get all sorts of weird symptoms, ranging from hand tingling to hip problems, because it's often related to bad posture, uneven muscle tone and the like. Weird facial pain is quite common.

Get to a good TMJ center like the one at Tufts Dentistry School (www.orofacialpain.com) for evaluation and treatment. Treatments can include mouth guards to stop grinding, intraoral massage from a PT, biofeedback, and more. You should also visit a clinical massage therapist in your area who specializes in trigger point massage.

Telling you the problem is "anxiety" doesn't help much. Anxiety can certainly feed muscle tension, but once you have muscle issues, you have to treat your muscles, not just your mood.