Neck Pain and Facial Weakness: When to See a Specialist

Stiffness in the shoulders and neck, swelling in the neck, and facial weakness?

I have numbness in the skin on the back of my right shoulder, and there is swelling extending along the right side of my neck.
The right side of my face feels weak starting from the eyebrow area, which causes me to often make strange facial expressions.
I have undergone an electrocardiogram, and it showed no issues.
I also have difficulty turning my head to the right and cannot turn to the right while sleeping, which leads to breathing difficulties and coughing.
Which specialist should I see?

Roy, 20~29 year old female. Ask Date: 2015/09/21

Dr. Gao Chunde reply Neurology

It is suspected that there may be inflammation, infection, or other mass lesions in the skull base or deep right neck.
A consultation with a neurologist or an otolaryngologist is recommended, and further examinations should be arranged if necessary.

Reply Date: 2015/09/21

More Info

Based on your symptoms of right shoulder skin numbness, swelling in the neck, facial weakness starting from the eyebrow area, difficulty turning your head to the right, and breathing difficulties, it is crucial to seek medical attention promptly. These symptoms could indicate several underlying issues that need to be evaluated by a specialist.

1. Neurological Evaluation: Given the facial weakness and numbness, it is essential to consult a neurologist. Facial weakness can be indicative of conditions such as Bell's palsy, which affects the facial nerve, or other neurological disorders that may require imaging studies like an MRI to rule out any structural abnormalities or lesions affecting the brain or nerves. The numbness in your shoulder and neck could also suggest nerve compression or irritation, possibly from cervical spine issues.

2. Orthopedic Consultation: Since you are experiencing difficulty turning your head and have swelling in your neck, it may be beneficial to see an orthopedic specialist, particularly one who focuses on the spine. They can assess for any cervical spine problems, such as herniated discs or degenerative changes that might be compressing the nerves and causing your symptoms.

3. Physical Therapy: Depending on the findings from your initial evaluations, physical therapy may be recommended to help improve your range of motion, strengthen the muscles around your neck and shoulders, and alleviate any nerve compression. A physical therapist can also provide exercises tailored to your specific needs and monitor your progress.

4. Pulmonary Evaluation: Since you mentioned experiencing breathing difficulties and coughing, it may also be wise to consult a pulmonologist. They can evaluate your respiratory function and determine if there are any underlying issues affecting your ability to breathe comfortably, especially if you are experiencing discomfort when lying down or turning your head.

5. Emergency Care: If your symptoms worsen, especially the breathing difficulties, it is crucial to seek emergency medical care. Difficulty breathing can be a sign of a serious condition that requires immediate attention.

In summary, the best course of action is to start with a neurologist to evaluate the facial weakness and numbness. They may refer you to an orthopedic specialist for further assessment of your neck and shoulder symptoms. Additionally, if breathing issues persist, a pulmonologist should be consulted. Early intervention is key to managing your symptoms effectively and preventing potential complications.

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