Facial Asymmetry and Neurological Symptoms: When to Seek Help

I'm not sure if I need to seek medical attention?

I have always felt that my face is asymmetrical; the right side feels looser and weaker, the corners of my mouth droop, and my right eye appears larger and is more prone to dryness (which has led me to habitually blink harder with my right eye).
I came across information about facial nerve dysfunction online and wonder if that might be the case, but my condition has not been sudden; I don't know when it started.
When I try to make facial expressions with more effort, I notice that my right side feels stiff and weak, and I also experience soreness.
While walking, I've been told that my right arm swings less, and I have always felt a lack of coordination in my limbs.

Additionally, I've recently experienced a sensation of shaking while lying in bed and looking at my phone, feeling as if the world is swaying.
This has startled me several times, making me think there was an earthquake, only to find out there wasn't.
It seems to happen when I exhale or hold my breath slightly.
I feel like my heart is beating quite fast under normal circumstances, and I often notice my heart racing.
I also experience a sensation of mild hypoxia in my brain, with my limbs feeling numb and weak, and I get easily breathless; even slight movements cause me to breathe rapidly.
I have a bit of anemia, but it's not severe.

I am curious if these issues are related and whether I need to see a doctor.
Although they don't significantly impact my daily life, I often find myself preoccupied with them.
Thank you, doctor.
🙏

kiki, 20~29 year old female. Ask Date: 2020/09/09

Dr. Jiang Junyi reply Neurology

Hello, based on your description, the issue of facial asymmetry can be evaluated through facial nerve electrophysiological tests to help clarify whether there is any facial nerve damage.
Regarding the dizziness and the sensation of vibrations you mentioned, it may be worth considering if these symptoms are related to your menstrual cycle.
Conditions such as migraines and hyperventilation syndrome could be involved.
However, other factors like anemia, autonomic dysfunction, and inner ear imbalance may also contribute to your symptoms.
It is essential to first rule out anemia or fluid deficiency that could lead to inadequate cerebral circulation.
Symptoms may improve with hydration and electrolyte replenishment.
Blood tests should include screening for possible complications (anemia, hyperthyroidism/hypothyroidism, diabetes, recurrent vestibular neuritis, autoimmune diseases, neurosyphilis, and central nervous system disorders).
I recommend discussing your evaluation and treatment options with a neurologist.
Wishing you good health and peace.
Dr.
Jiang, Department of Neurology, cares about you.

Reply Date: 2020/09/09

More Info

Facial asymmetry and neurological symptoms can be concerning, especially when they manifest in ways that affect daily life. Based on your description, it seems you are experiencing a range of symptoms that could be related to facial nerve dysfunction, as well as potential issues with coordination and cardiovascular symptoms.
Facial nerve dysfunction, often referred to as facial nerve palsy or Bell's palsy, can lead to noticeable asymmetry in facial expressions. Symptoms may include drooping of one side of the face, difficulty closing the eye on the affected side, and weakness in the muscles that control facial expressions. The feeling of heaviness or weakness in the right side of your face, along with the sensation of stiffness and pain, aligns with these symptoms. It’s important to note that while some cases of facial nerve dysfunction can be sudden and acute, others may develop gradually, as you have described.

The additional symptoms you mentioned, such as the sensation of your heart racing, feelings of breathlessness, and the perception of your surroundings shaking, could indicate a separate set of issues. The feeling of dizziness or a sensation akin to an earthquake when lying down may suggest vestibular dysfunction or anxiety-related symptoms. The fact that you experience these sensations when holding your breath or exhaling could point towards a hyperventilation syndrome, which can occur in response to anxiety or panic.

Your mention of experiencing mild anemia could also be relevant. Anemia can lead to symptoms such as fatigue, weakness, and shortness of breath, especially during physical exertion. If your anemia is causing significant fatigue or weakness, it could exacerbate the feelings of dizziness and breathlessness you are experiencing.

Given the complexity of your symptoms, it is crucial to seek medical attention. A healthcare provider can perform a thorough evaluation, which may include a neurological examination, blood tests to assess your anemia, and possibly imaging studies to rule out any structural issues in the brain or inner ear that could be contributing to your symptoms.
In terms of treatment, if facial nerve dysfunction is diagnosed, options may include corticosteroids to reduce inflammation, physical therapy to improve muscle function, and in some cases, antiviral medications if a viral cause is suspected. For the other symptoms, addressing anxiety through therapy, lifestyle changes, or medication may be beneficial.
In summary, while your symptoms may not significantly impact your daily life at the moment, they are concerning enough to warrant a medical evaluation. Early intervention can lead to better outcomes, especially for conditions that may be progressive or require specific treatments. Please consider scheduling an appointment with a neurologist or your primary care physician to discuss your symptoms in detail and explore appropriate diagnostic and treatment options.

Similar Q&A

Understanding Facial Asymmetry: Is It a Stroke or Something Else?

Hello, doctor. Recently, I've been experiencing a tingling and swelling sensation on one side of my face. When I relax, I notice that my eye and mouth appear uneven, but my arms and legs are normal with no abnormalities. I can close my eyes and mouth, and it seems somewhat s...

Dr. Lin Zijing reply Neurology
The main symptoms of facial nerve paralysis include facial asymmetry, inability to close the eyelids, tearing, taste disturbances, a sensation of food stagnation in the mouth, and difficulty drinking without spilling. The affected side may appear droopy, and the eye may appear mi...

Understanding Language Barriers: Possible Neurological Issues Explained

Hello doctor, my friend suddenly exhibited unusual symptoms a few days ago. He couldn't understand what was being said to him, his responses were off-topic, and his gaze and mental state seemed somewhat scattered. After a few days, his gaze has mostly returned to normal, but...

Dr. Ye Boshou reply Neurology
There may be signs of a brain condition in the language area along with facial asymmetry. Please seek immediate consultation at a neurology clinic, as this could be indicative of a stroke or other neurological issues.

Understanding Facial Asymmetry: When to See a Neurologist

Doctor, I would like to ask if my colleagues have recently mentioned that my mouth appears to be slightly crooked when I speak. Could this be related to cranial nerves? If I go to the hospital, should I see a neurologist? Could you please let me know? Thank you!

Dr. Ye Boshou reply Neurology
This description may indicate facial nerve paralysis; please visit the neurology clinic for a physical examination.

Understanding Facial Nerve Dysfunction: Causes and Treatment Options

On the morning of June 21, 2004, I suddenly woke up and noticed that the facial expressions on both sides of my face were not coordinated. When I tried to make some difficult facial expressions or exaggerated faces that I could easily do before, I found it difficult to do so as e...

Dr. Lai Lunxiang reply Neurology
Based on your description, you may be experiencing "facial nerve paralysis." However, you did not specify which side is affected. It is recommended that you seek prompt evaluation and treatment from a neurologist.