Facial Numbness and Headaches: When to See a Neurologist

Headache and facial numbness?

Hello, Doctor! I would like to ask about some symptoms I've been experiencing.
For the past year, I've had frequent numbness on the left side of my face.
Previously, I also experienced headaches that felt like pressure and dizziness.
I took traditional Chinese medicine, which helped a bit, but now the symptoms have returned.
Additionally, I feel very fatigued every day; even after sleeping a lot, I still feel unrested.
My vision has also worsened.
Would it be appropriate to see a neurologist for these symptoms? What could be the underlying issues with my body?

vera, 20~29 year old female. Ask Date: 2008/03/31

Dr. Lin Zijing reply Neurology

Numbness on one side of the face may be caused by issues or dysfunction of the trigeminal nerve, which is responsible for facial sensation.
Sometimes, it can be a precursor to facial nerve paralysis, peripheral circulation disorders, or may have no identifiable cause.
In a small number of cases, it can be a sign of a minor stroke.
You can perform some self-tests: 1.
Make facial expressions in front of a mirror; if you can do this, it indicates that the facial nerve is functioning well.
2.
Wash your face with hot and cold water and have someone lightly poke your face with a toothpick to check for any abnormal sensations.
If you notice any abnormalities, it suggests an issue with the trigeminal nerve.
If the above tests show no problems, there is generally no need to worry about nerve issues.
Tension-type headaches are often related to muscle tightness, usually caused by excessive stress, poor posture, or inadequate sleep, and should be addressed through a regular lifestyle and exercise.
If symptoms persist, it is advisable to seek assistance from a neurologist for treatment.
Thank you.

Reply Date: 2008/03/31

More Info

It sounds like you are experiencing a complex set of symptoms that could be related to several underlying issues. Given your description of persistent left-sided facial numbness, headaches that feel like pressure, dizziness, fatigue, and changes in vision, it is indeed appropriate to consult a neurologist. Neurologists specialize in diagnosing and treating conditions related to the nervous system, which includes the brain, spinal cord, and peripheral nerves.

Potential Causes of Your Symptoms
1. Nerve Compression or Irritation: The facial numbness you are experiencing could be due to compression or irritation of the facial nerve (cranial nerve VII) or the trigeminal nerve (cranial nerve V). This can occur due to various reasons, including anatomical variations, tumors, or even inflammation.

2. Migraine or Tension-Type Headaches: Your description of headaches that feel like pressure could suggest migraine or tension-type headaches. Migraines can sometimes present with neurological symptoms, including numbness or tingling in the face. Tension-type headaches are often associated with muscle tightness and can lead to a feeling of pressure in the head.

3. Cervical Spine Issues: Given that you also mentioned fatigue and dizziness, it’s possible that there could be an issue with your cervical spine, such as a herniated disc or cervical spondylosis, which can lead to nerve compression and subsequent neurological symptoms.

4. Multiple Sclerosis (MS): While less common, MS can present with facial numbness and fatigue. It is a demyelinating disease that affects the central nervous system and can cause a wide range of neurological symptoms.

5. Anxiety and Stress: Chronic stress and anxiety can lead to physical symptoms, including fatigue, headaches, and muscle tension, which may exacerbate your perception of numbness and discomfort.

6. Other Medical Conditions: Conditions such as diabetes, vitamin deficiencies (especially B12), or thyroid disorders can also lead to neurological symptoms, including numbness and fatigue.

When to See a Neurologist
Given the persistence and complexity of your symptoms, it is advisable to see a neurologist. Here are some reasons why:
- Persistent Symptoms: Since your symptoms have been ongoing for a year and are affecting your quality of life, it is important to seek specialized care.

- Neurological Evaluation: A neurologist can perform a comprehensive neurological examination, which may include imaging studies (like MRI or CT scans) to rule out structural causes of your symptoms.

- Tailored Treatment: Depending on the diagnosis, a neurologist can provide targeted treatment options, which may include medications, physical therapy, or referrals to other specialists if necessary.

What to Expect During Your Visit
During your appointment, be prepared to discuss:
- The onset and duration of your symptoms.

- Any triggers or patterns you have noticed.

- Your medical history, including any previous diagnoses or treatments.

- Family history of neurological conditions.

- Lifestyle factors, including stress levels, sleep patterns, and diet.

Conclusion
In summary, your symptoms warrant a thorough evaluation by a neurologist. They can help determine the underlying cause of your facial numbness, headaches, and fatigue, and guide you toward appropriate treatment options. It’s important to address these symptoms early, as they can significantly impact your daily life and overall well-being. Don’t hesitate to seek help; your health is paramount.

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