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loss of facial feelings or sensation
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loss of facial feelings or sensation

hi, i  have a 24 years old son who is fully healthy but for the last three weeks he starts to lose parts of his sense in diffeent parts of his face starting with his lips then goes on to his teeth, tounge and cheeks. it is not numbness nor a complete loss of feeling. should i be worry about that and what tests does he needs to have if there is any. please i need you answer. thank you.
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Avatar_dr_f_tn

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 a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

One-sided numbness is most commonly due to a problem in the brain (as opposed to other areas of the central nervous system such as the spinal cord or peripheral nerves) or trigeminal nucleus/nerve. Many possibilities exist, and depend somewhat on his age, risk factors, and the nature of his symptoms (whether or not the numbness started suddenly or gradually, whether it is a complete loss of sensation or a tingling, whether it is an objective finding on examination or it is only a feeling that he has etc).

Facial numbness can have several causes. These include migraine/headache, anxiety/panic attacks, multiple sclerosis, stroke/TIA, tumor, vascular malformations, seizure and trigeminal neuralgia to name a few.

The most concerning cause of numbness on one side is a stroke. Please understand I am not trying to imply your son had a stroke, but only that this is one possibility. Strokes occur predominantly in people with risk factors: smokers, high cholesterol, diabetics, hypertensives, and people over the age of 55. However, they can occur in any age. If his numbness was due to a stroke, it would start somewhat suddenly (over minutes) and would likely persist without significant improvement.

Other potential causes as already mentioned include multiple sclerosis, a brain tumor, a vascular malformation and others. If the numbness is transient (lasting for example for minutes up to 30 minutes then resolving) could be due to a migraine (the aura of migraine, in which case following the numbness, a headache occurs) or seizures.

It is difficult to give you a more focused differential based on the symptoms you provide.   He would benefit from evaluation by a neurologist. It would be important to you to provide information, if applicable, on headache history, rashes, additional findings in the arms/legs, and social history including life stressors, smoking history, and occupation. These items will help guide the diagnosis and workup.

Depending on his history and physical examination, he/she may choose to order an MRI of the brain, which would be able to assess for several of the disorders discussed above. Also, it would be recommended to have an MRA of the blood vessels including carotids and Circle of Willis.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

2 Comments
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1716541_tn?1308853432
hi, and thank you for answering my question. but to make the picture more clear to you i would like to add that he is not smoker and not alcoholizm. he has some stress at work as he is new to it, and he was engaged then break up and this put some stress on him. the feeling he has on his face is not acctually full numbness and it's not on one side of the face. he lost partial sense of his lips at the begigging then goes to his tounge then cheeks. it's not a matter of moments it is lasting with him. some days he feels weaknesses in his arms but not in his legs. he doesn't have any history of chronich headich and he is otherwise fully healthy. does he needs the MRI alone or with other kind of tests? and what is the MRA of the blood vessel? thank you.
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