Lip Numbness: COVID-19 Symptoms or Stroke Warning?

Numbness of the lips?

Hello, doctor.
During my COVID-19 diagnosis at the end of August, I experienced lip numbness, which has since become more frequent, often lasting over a day.
The numbness is located on the outer part of my lips.
Is this a symptom of COVID-19, or could it be a warning sign related to a stroke? I do not have a history of hypertension or diabetes.
How should I monitor this, and when should I seek medical attention? Thank you.

A-Liang, 30~39 year old female. Ask Date: 2022/10/03

Dr. Jiang Junyi reply Neurology

Dear Ms.
Liang,
You mentioned that "the numbness in your lips is located on the outer edge." I would like to know if you are experiencing any other symptoms of numbness or tingling in your limbs.
Similar symptoms are commonly seen in cases of hyperventilation.
This occurs because the level of carbon dioxide in the blood decreases, leading to an increase in pH, a condition known medically as "respiratory alkalosis," which can cause systemic reactions and symptoms.
Commonly observed effects include vasoconstriction and decreased blood calcium levels.
The reduced blood flow to the brain due to vasoconstriction can result in dizziness, numbness (especially around the lips and in the upper limbs), and weakness.

The diagnosis of "hyperventilation syndrome" requires the exclusion of physiological diseases; therefore, basic tests such as pulmonary function tests, electrocardiograms, chest X-rays, and blood tests are necessary.
A definitive diagnosis can be made through arterial blood gas analysis to confirm that the patient indeed has low carbon dioxide levels (though drawing arterial blood can be uncomfortable).
If your symptoms persist or worsen, I recommend consulting a neurologist to rule out hyperventilation or issues related to the brainstem.
Thank you for your inquiry, and feel free to discuss any related questions further! Wishing you good health and peace.
Dr.
Jiang Junyi, Tao Medical Center

Reply Date: 2022/10/03

More Info

Lip numbness can be concerning, especially in the context of recent COVID-19 infection. It is essential to differentiate between symptoms that may be related to COVID-19 and those that could indicate a more serious condition, such as a stroke.

Firstly, numbness or tingling in the lips can occur for various reasons. In the context of COVID-19, some patients have reported neurological symptoms, including altered sensations, which may manifest as numbness or tingling. This could be due to the virus's impact on the nervous system or as a result of inflammation caused by the immune response to the infection. However, it is important to note that while these symptoms can occur, they are not the most common manifestations of COVID-19, which typically include respiratory symptoms, fever, and fatigue.

On the other hand, lip numbness can also be a warning sign of a stroke, particularly if it is accompanied by other symptoms such as weakness on one side of the body, difficulty speaking, confusion, or severe headache. The classic acronym used to identify stroke symptoms is FAST: Face drooping, Arm weakness, Speech difficulties, and Time to call emergency services. If you experience any of these symptoms, it is crucial to seek immediate medical attention.

Given your history of COVID-19 and the recurring nature of your lip numbness, it would be prudent to consult a healthcare professional. They may recommend a thorough evaluation, which could include a neurological examination and possibly imaging studies like a CT scan or MRI to rule out any serious conditions such as a stroke or other neurological disorders.

In the meantime, keep track of the frequency and duration of your symptoms. Note any accompanying symptoms, such as headaches, dizziness, or changes in vision, as these details can be helpful for your healthcare provider in making a diagnosis. Additionally, consider factors that may contribute to your symptoms, such as stress, anxiety, or any recent changes in medication or health status.

In summary, while lip numbness can be associated with COVID-19, it is essential to consider the possibility of more serious conditions like a stroke. Given the potential implications, I recommend that you seek medical advice promptly to ensure appropriate evaluation and management of your symptoms. Your health and safety are paramount, and timely intervention can make a significant difference in outcomes for neurological conditions.

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