Numbness on the right side of the face

Patient

Q: I have severe numbness on the right side of my face, which includes my tongue lips and gums. I've had this for appx. 3 years. I have Received (2) mri's and have seen neurologist and ears,nose and throat specialists and dentist. I have not received a diagnosis from any of these specialists. It seems to get worse when I eat sodium.

Doctor

A:   Sensation from the face is transmitted through branches of the trigeminal nerve, the fifth cranial nerve. Sensory loss to the face can be an isolated symptom, but more commonly it is accompanied by other symptoms, such as loss of sensation or weakness in other parts of the body. People who experience facial numbness should seek medical advice, since it can be the first indication of an underlying disease. Some tumors as scwhannomas, which are tumors that grow from the nerve sheath, can present with facial pain and numbness that progress over the course of several months. They are typical of Neurofibromatosis, this is a hereditary disorder in which multiple schwannomas grow on many different nerves, leading to symptoms that include loss of hearing and loss of sensation in the face. Autoimmune diseases can cause widespread loss of sensation in many areas of the body, or sensory loss that is limited to the face. Stroke in the area of the middle cerebral artery, which supplies the sensory part of the cortex, can lead to numbness on the other side of the face and body. Sensory loss is often accompanied by paralysis and other neurological problems. Occasionally, strokes that affect smaller arteries lead to isolated sensory loss, for example if the stroke affected a small area in the thalamus, an area deep in the brain, maybe the only symptom would be tingling and numbness in a small area of her face. I strongly suggest a reevaluation, a second opinion, to determine the cause of your symptoms.

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