Facial Numbness: Insights for Ankylosing Spondylitis Patients - Neurology

More Info

---

Facial numbness can be a perplexing symptom, especially for patients with Ankylosing Spondylitis (AS). AS is primarily known for causing inflammation and pain in the spine and sacroiliac joints, but it can also have systemic effects that might contribute to neurological symptoms, including facial numbness.
In your case, the intermittent numbness in the right side of your face and lip, along with the ear, raises several considerations. First, it's important to note that while AS primarily affects the spine, it can also lead to complications that may affect the nervous system. For instance, inflammation in the cervical spine could potentially impact the nerves that innervate the face. The cervical spine houses the nerve roots that branch out to various parts of the body, including the facial region. If there is any compression or irritation of these nerves due to cervical disc herniation or inflammation, it could manifest as numbness or tingling in the face.

You mentioned that you have undergone MRI scans of both the brain and cervical spine, which ruled out significant issues in the brain and indicated some cervical disc protrusions. While the protrusions may not be severe enough to warrant surgical intervention, they could still be contributing to your symptoms. It's worth discussing with your healthcare provider whether conservative treatments, such as physical therapy or specific neck exercises, could help alleviate any nerve compression.

Regarding the medication you are currently taking, it’s understandable to be cautious about adding another medication like Gabapentin (千憂) to your regimen, especially since you are already on multiple medications for AS. Gabapentin is often prescribed for neuropathic pain and can help with symptoms like numbness and tingling. However, it does come with potential side effects, including dizziness, fatigue, and cognitive changes. It’s crucial to weigh the benefits against the risks, and this is a conversation best had with your prescribing physician. They can help you assess whether the potential relief from Gabapentin would outweigh the risks, especially considering your current medication load.

Additionally, if your facial numbness persists or worsens, further investigations may be warranted. This could include a referral to a neurologist for a more comprehensive evaluation of your symptoms. They might consider additional tests, such as a cervical spine MRI focused on the specific levels where protrusions are present, or even a lumbar puncture if there is suspicion of an inflammatory or demyelinating process affecting the nervous system.

In summary, while your facial numbness may not be directly caused by AS, the interplay between your spinal health and neurological symptoms cannot be overlooked. It’s essential to maintain open communication with your healthcare team, discuss your concerns about medications, and explore all possible avenues for treatment and relief. Managing AS effectively often requires a multidisciplinary approach, and addressing neurological symptoms is an important part of your overall care.