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face stiffness
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face stiffness

hi dr....left side of my face feel stiff when i moved my muscle or jaw...i can see some nerve moving when i try to move my jaw...the stiffness come from the chick side of my face or beside my nose...i went to doctor and doctor said is due to infection because i has flu at the same time...i used to develop bell's palsy as well...what actually happen to me? is that an infection or something else?...hope to get reply soon....
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Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the cause of your symptoms is nor whether or not it is related to an infection. However, in general, stiffness in the cheek and jaw area may be due to problems with the temporo-mandibular joint (TMJ), the joint located somewhat in front of the ear which connects the jaw to the skull. Movement at this joint can often cause pain when there is irritation to the joint such as occurs with teeth grinding. Teeth grinding may often occur during sleep, in which case a teeth-guard may be necessary to protect the teeth, or during the day if a person is under stress. Pain in the face may also be referred, from the ear and the sinuses. Usually, there is no visible nerve seen during jaw movement, it is possible you are seeing movement of the muscles or TMJ. If you do have a history of Bell's palsy, another possibility of the contractions you are seeing, though less likely is called synkinesis: sometimes after bell's palsy when the nerves regenerate (redevelop), they can have aberrant development, such that for example when you blink your eyes, the muscles of your chin contract. However, this is usually very subtle (not obvious).

A neurologic cause of facial pain is trigeminal neuralgia. Symptoms are severe shooting pains in the face rather than face stiffness. There is not visible contraction seen with trigeminal neuralgia.

Here is some information about Bell's Palsy below.

There are 12 nerves, called cranial nerves, that supply our face. One of these nerves is called the 7th cranial nerve, of facial nerve. It innervates several parts of the face, including the muscles we use for facial expression (smiling, closing the eyes, looking surprised). It also has such functions as helping us perceive taste on part of our tongue, and dampens sounds so that they are not too loud. It is also involved in our eyes tearing and in our mouth watering.

Bell's Palsy (named after the physician who discovered it) is a condition that results from a lack of function of the facial nerve, and the problem leading to this dysfunction can be anywhere from the origin of the nerve to anywhere in its path where it gives of smaller nerves to supply all the areas described above.

Weakness of an entire side of the face (including the forehead, eye, cheek, and neck muscles) occurs. A person with Bell's palsy is unable to raise up their forehead, close their eye, smile, or contract their neck muscle on the affected side.

Many patients complain of sensory symptoms such as numbness or tingling in the face on the same side of the weakness. Where the lesion is determines what additional symptoms there are. If the lesion is close to the origin of the nerve, then in addition to complete weakness of the face (on the same side of the affected nerve), symptoms will include lack of tearing from the eye on the same side. If the lesion involves the nerve prior to where it branches off to the tongue, taste may be involved. And so on.

It could be "idiopathic", meaning having no known, identifiable cause, or secondary to other processes, including but not limited to infections (such as Lyme disease or Herpes infection) or inflammation (such as in the condition called sarcoidosis).  If it is isolated, meaning that no other findings are present, then it is highly unlikely to be due to a stroke, tumor, or other causes. However, if for example, the body on the side opposite of the facial weakness is also weak, the latter causes need to be ruled out.

The extent of recovery will depend on the cause, and the age of the patient. In idiopathic cases in younger individuals, complete or near complete recovery of the function of the facial nerve over weeks to 2-3 months is expected. In some cases, there is partial recovery, and much less commonly, there is little recovery of function.

If recurrent Bell's palsy occurs, meaning if it occurs on one side of the face then the other, or if it occurs more than once on the same side, evaluation to exclude secondary causes is warranted, and in that case evaluation by a neurologist is important.

Thank you for this opportunity to answer your questions, good luck.
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