Persistent Neck and Facial Symptoms: A Neurology Perspective

What is the reason for this?

Hello, doctor! For several years now, I have been experiencing stiffness in my shoulders and neck, along with swelling in my neck.
I have also noticed symptoms such as frequent fatigue, increased anxiety, and a general feeling of heaviness.
Additionally, I feel weakness around my right eyebrow area; for instance, when I close my left eye, my right eye feels weak and wants to close as well.
Conversely, when I close my right eye, my left eye functions normally.
The discomfort in my right eye is often accompanied by a strange expression of raising my eyebrows.
I have previously undergone EEG and echocardiogram tests, which showed no issues.
Another symptom is that sometimes after a little physical activity, I experience a temporary numbness on one side of my body that lasts for a few seconds before returning to normal.
An ENT specialist mentioned that the issue with my neck is just muscle-related and not a concern.
This has been troubling me for a long time.
What should I do now?

Han Sheng, 20~29 year old female. Ask Date: 2015/10/01

Dr. Jiang Junyi reply Neurology

Hello, based on your description, the common cause of your symptoms is cervical myofascial pain.
Prolonged periods of looking down can lead to overuse of the muscles in the back of the neck, resulting in neck and shoulder discomfort.
Initially, resting may alleviate the pain, but it can progressively worsen and affect your daily activities.
At the affected site, you may sometimes feel palpable myofascial trigger points beneath the skin.
As for the numbness on one side of your body, it may be a result of nerve root compression.
I recommend consulting with a neurologist or a rehabilitation physician for further evaluation and treatment.
Wishing you good health and well-being.

Reply Date: 2015/10/01

More Info

Understanding persistent neck and facial symptoms can be quite complex, especially when they involve neurological aspects. Based on your description, it seems that you are experiencing a combination of symptoms that may suggest a neurological issue, particularly involving the facial and neck regions.
The symptoms you mentioned, such as neck stiffness, facial weakness, and episodes of temporary numbness, could be indicative of several conditions. One possibility is a form of cervical radiculopathy, where nerve roots in the neck are compressed or irritated, leading to pain, weakness, or numbness that can radiate into the arms or face. This could explain the stiffness in your neck and the facial weakness you are experiencing.

Another consideration is the possibility of a condition known as myofascial pain syndrome, which can cause muscle tightness and discomfort in the neck and shoulders, potentially leading to referred pain or sensations in the face. The fact that you feel a sense of heaviness and tension could also be related to anxiety or stress, which can exacerbate physical symptoms and create a cycle of discomfort.

Your experience of feeling weak in one eye when trying to close it while the other eye functions normally could suggest a neurological issue, such as facial nerve dysfunction. This could be due to a variety of causes, including Bell's palsy, which is a temporary weakness or paralysis of the muscles on one side of the face. However, given the complexity of your symptoms, it is essential to rule out other potential causes, including more serious conditions like multiple sclerosis or other neurological disorders.

Given that you have already undergone tests like EEG and cardiac evaluations without significant findings, it may be beneficial to pursue further neurological evaluation. A comprehensive assessment by a neurologist could help determine if there are underlying issues contributing to your symptoms. This may include imaging studies such as an MRI of the brain and cervical spine to look for any structural abnormalities or lesions that could be affecting your nerves.

In the meantime, managing your symptoms through physical therapy could be beneficial. A physical therapist can work with you to improve neck mobility, strengthen the surrounding muscles, and address any postural issues that may be contributing to your discomfort. Additionally, stress management techniques such as mindfulness, yoga, or cognitive-behavioral therapy could help alleviate some of the anxiety and tension you are experiencing.

It is also important to maintain a healthy lifestyle, including regular exercise, a balanced diet, and adequate sleep, as these factors can significantly impact your overall well-being and may help reduce some of the symptoms you are experiencing.

In summary, your symptoms warrant a thorough evaluation by a neurologist to explore potential underlying causes. In the meantime, consider physical therapy and stress management techniques to help alleviate your discomfort. Remember, you are not alone in this, and seeking help is a crucial step towards finding relief and improving your quality of life.

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