Left Facial Numbness: Possible Causes and Concerns

Numbness in the left cheek?

Hello Doctor, my question is that initially I felt like there was a foreign body in my eye, but after visiting an ophthalmologist, they said there was no foreign body.
I have also experienced a tingling sensation in the left side of my cheek.
The ophthalmologist suggested I see a neurologist.
The sensation extends from below my left eye to the left side of my lip, but I can move normally and close my eye completely.
However, my eye still feels like there is something in it.
I did some research online, and some people mentioned that it could be wisdom teeth pressing on nerves.
I have a wisdom tooth that has been erupting in the back left for some time.
Could it be possible that the wisdom tooth is causing the pressure? Thank you, Doctor.

Liu Xiansheng, 20~29 year old female. Ask Date: 2016/01/06

Dr. Jiang Junyi reply Neurology

According to your description, the facial sensation abnormalities you mentioned are primarily governed by the trigeminal nerve (the fifth cranial nerve).
The area extending from below the left eye to the left side of the lip corresponds to the second division of the trigeminal nerve.
As for facial movement, it is controlled by the seventh cranial nerve, the facial nerve.
Possible examinations during your visit may include:
Neurological examination: To identify specific areas of pain and determine the nerve distribution causing the pain, which will help establish a diagnosis and potential causes.

Dental examination: To check for any abscesses near the nerves.

Blood tests: To check for signs of infection.

X-rays or imaging studies: To assess the possibility of nerve compression.

Neuropathic pain can be treated with medical management and physical therapy, while surgical intervention may be considered for some refractory cases.
Pain management may include analgesics.
Anticonvulsants or antiepileptic medications are used to treat the pain and muscle tightness associated with trigeminal neuralgia.
It is advisable to consult a neurologist for discussion and treatment.
Wishing you good health and peace.

Reply Date: 2016/01/06

More Info

Hello! Thank you for reaching out with your concerns about the numbness and discomfort on the left side of your face, particularly around your eye and mouth. Based on your description, it seems you are experiencing a combination of symptoms that could be related to several underlying issues.

Firstly, the sensation of having something in your eye, despite being cleared by an ophthalmologist, could be due to a few reasons. It might be related to dry eye syndrome, where the eye does not produce enough tears, leading to irritation. Alternatively, it could be a sign of a neurological issue, especially since you mentioned numbness extending from your left eye down to your lip.

The numbness you are feeling on the left side of your face could potentially be linked to a condition affecting the facial nerve (cranial nerve VII), which controls the muscles of facial expression. This could manifest as facial weakness or numbness, even if you can still perform facial movements normally. Conditions like Bell's palsy, which is often idiopathic, can cause such symptoms. However, since you mentioned that you have normal movement and can close your eye completely, this might suggest that the facial nerve is not severely affected.

Another possibility you mentioned is the impact of your wisdom tooth. Wisdom teeth, particularly if they are impacted or growing in an unusual position, can indeed exert pressure on nearby nerves, including the trigeminal nerve (cranial nerve V), which is responsible for sensation in the face. This pressure could lead to sensations of numbness or tingling in the areas it innervates, including the cheeks, lips, and even the eye area. If your wisdom tooth is positioned in a way that it is pressing against the nerves, it could certainly contribute to the symptoms you are experiencing.

Given the complexity of your symptoms, it would be prudent to follow up with a neurologist, as they can perform a thorough examination and possibly recommend imaging studies, such as an MRI, to rule out any serious conditions affecting the brain or nerves. They may also consider conducting nerve conduction studies to assess the function of the facial and trigeminal nerves.

In the meantime, if the sensation of having something in your eye persists, you might want to try lubricating eye drops to alleviate any dryness or irritation. If you experience any worsening of symptoms, such as increased numbness, weakness, or changes in vision, it is important to seek medical attention promptly.

In summary, while your symptoms could be related to a variety of factors, including potential nerve compression from your wisdom tooth or a neurological condition, a thorough evaluation by a specialist will provide clarity and guide appropriate treatment. Please take care and do not hesitate to seek further medical advice.

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