What is this facial tingling/numbeness all about?

[PrincessYo]

It's good to know that there are other people who are experiencing the same thing and that you're not just experiencing "anxiety".  For the past three years, I have been having left facial tingling/numbness intermittingly.  Sometimes I have a headache with these symptoms, but most of the time the syptoms stand alone.  There is also the feeling that my left eye is about to fall and my lips are going to twist up and remain that way.  In August of 2005, after the 4th miscarriage, I presented to ER with right-sided headache, slurred speech, impaired mobility and a strange metallic taste in the mouth.  At first I thought I was having a stroke or TIA, which to this day remains unconfirmed.  They did, in fact, find a tiny clot on the lower left lung and put me on coumadin. (I did not stay on the therapy).  For the 5th and 6th try at pregnancy, I was placed on Lovenox in order to regulate coagulability.  Well, the last miscarriage was in September of 2007 and I had a partial hysterectomy in Nov. 2007.  But, these episodes of tingling and numbness (no real pain) are quite frequent and sometimes I have chest pain and pain in the calves.  They are not sure what is going on--I've been given Rxs for Imitrex, Lorazapam (Anxiety) and Tegretol (which I haven't taken).  I don't want to start any meds until I have a confirmed diagnosis/prognosis.  I had a MRI of the brain on 6/4 and they still haven't gotten the results.  I just placed a call and requested that they fax them over to my neuro.  How's that for follow up on their part?!  

[PrincessYo]

Thanks for your replies.  I'm exhausted from all the testing, but I have to get to the bottom of this.

[patsy10]

Have you been checked for lyme disease?  It's endemic in NY.

[dr_simran]

Hello Dear,

The goal of pharmacologic therapy is to reduce pain. Carbamazepine (Tegretol) is regarded as the most effective medical treatment. Additional agents that may benefit selected patients include phenytoin (Dilantin), baclofen, gabapentin (Neurontin), Trileptol and Klonazepin.

When drug therapy is unsuccessful, invasive procedures are tried. Nerve blocks using local anesthetics can be injected into the trigger area or pain site for temporary relief. Glycerol injections, which can be done under general anesthesia or following intravenous sedation, can destroy the fibers that conduct triggering impulses, with less sensory loss. While glycerol injections have a high initial success rate, the incidence of pain recurrence is great -- after five years. The most commonly used surgical technique is microvascular decompression, an inpatient procedure requiring general anesthesia that allows surgeons to reposition arteries or veins pressing on the trigeminal nerve. Upwards of 80% of patients experience long-term pain relief and retain normal sensation in the face with a lower chance of recurrence, although recurrences do occur.
Radiofrequency gangliolysis (RFG) involves wounding the gasserian ganglion, the large, flat root of the trigeminal nerve. Guided by x-ray technology, the surgeon inserts a needle through the cheek and into the rootlets behind the gasserian ganglion to inject a radiofrequency current. This current heats and destroys selected portions of the gasserian ganglion thought to be responsible for the pain. A percutaneous procedure, RFG provides relief in almost all patients; however, the recurrence rate following RFG is 20 to 30%. RFG is used especially to treat debilitated or elderly patients who would be at risk from major surgery.
In cases where microvascular decompression cannot be tolerated or RFG has failed, peripheral neurectomy or neurolysis may be performed. This surgical and chemical destruction of the peripheral branches of the trigeminal nerve produces dense numbness to alleviate pain. Relief rarely lasts more than one year, necessitating repeat procedures.
The fused vertebrae can cause such pains,but unless they are detected on MRI the pathology cannot be diagnosed.You should go in for a MRI to see if any degenerative changes have taken place.
Refer http://www.neurosurgery.pitt.edu/imageguided/trigeminal_neuralgia.html

http://www.stoppain.org/pain_medicine/con

[PrincessYo]

Yes, they did the entire antiphospholipid and anticardiolipin panel and still no explanation.

[sheba968]

Just wondering- have you ever been checked for antiphospholipid syndrome? It could possibly explain the miscarriages.

[PrincessYo]

Oh,I forgot to mention that the chirpractor said I have fused vertebrae at the C2-C3 level, which very well could be the culprit of these episodes.

[PrincessYo]

Thanks so much for your post.  I just got the results back from the MRI and the doctor said everything was fine although he thought it was TN.  As for the TN, I don't really have face pain per se, but more tingling/numbness....no sharp pin-like pain.  Now what do I do?

[dr_simran]

Hello Dear,
Your pain seems to be due to neuralgia of either trigeminal or occipital nerves.The diagnosis can be confirmed by a neurologist.Following are the symptoms-
Trigeminal neuralgia is a facial pain syndrome consisting of  sharp, lancinating pain in the face. The pain is often described as shock-like stabs of pain. The pain is only on one side of the face and may be elicited by touching trigger points in the skin of gums. There is no associated numbne. Often there may spontaneous remissions from pain lasting weeks to years. Interestingly, this pain usually responds to carbamazepine (Tegretol), an oral anticonvulsant medication.
Trigeminal neuralgia is usually caused by compression of the sensory (trigeminal) nerve within the skull by a small artery or vein at the point where the nerve joins the brain stem.You should consult a neurologist regarding these details.
Refer http://www.sd-neurosurgeon.com/diseases/tn.html.
Best