Medical Dopers: I could use some ideas and advice.

Two weeks ago today, the space above my right front tooth felt numb. Since then, it has spread across the right side of my face. From my jaw to a good portion of my scalp and right ear is numb.

It almost perfectly bisects my face. The left side of my face is fine and I can feel it. The right side I can only feel pressure and at times some itching. It encompasses my upper palate, teeth and gums on the right side, as well as my eyeball.

I saw an ER doc, they did a CATscan and didn’t find a lesion or tumor Sunday before last. My appointment to see a Neurologist isn’t until 8/6.

Any ideas on what this could be and are there things I could do to alleviate the symptoms?

I drink shakes now because I end up biting my tongue and my cheek when I try to eat anything solid. I do have muscle control but no feeling. Help.

While I’m not a doctor, but I do have some personal experience in a related condition that I’m not going to get into at the moment because it would needlessly scare you…

Rather than a CAT scan, did you get an MRI where they gave you an injection? Because if you didn’t get an MRI with an injection of marker dyes, that’s probably the first thing the neurologist is going to do. Do you have odd sensations of fullness, diminished hearing, or ringing in your right ear? You’ll probably get a hearing test too. What is your age? Do you have any popping or clicking in your jaw when you chew?

You’re obviously having some sort of problem with your 7th cranial nerve. There are two CN VII nerve bundles, one for each side of your face. Obviously a neurologist or otolaryngologist will have to diagnose the problem. Count yourself lucky, it took me 3 months to get an appointment with a neurologist.

On the side of your face that’s numb, does it appear that your face is sort of drooping on that side, especially around the eye? A friend of mine had sudden numbness and drooping on one side of her face, and they diagnosed it as Bell’s Palsy (informational site here).

I don’t know if that’s what it is, but it wouldn’t hurt to read up on it. Basically, Bell’s Palsy largely resolves itself, sometimes with the assistance of antibiotics if it’s determined that there’s an infection causing pressure on the facial nerve.

HTH and good luck. :slight_smile:

No, my face is not drooping.

As it has severely diminished feeling, it feels very strange to me, but feels normal to my husband.

No… I did get a CATscan and not an MRI. No injection, and there is a difference between the machines. I’m sure the MRI is next.

Chas.E: If you care to share here or via e-mail what happened to you, that would be helpful. I’d rather have a clear idea of what this could be rather than the anxiety of not knowing and not having an idea that I am under right now.

[major nitpick]
The 7th nerve has nothing to do with the sensation on the face. The 7th nerve is primarily involved with the muscles of facial expression (smiling etc.)

The 5th nerve does control facial sensation (and also controls chewing, jaw movement, and the like)
[/major nitpick]

I will not offer specific advice but will say that the normal CAT scan is, of course, reassuring. Your neurologist may also wish to do an MRI. Perhaps more importantly, he/she will do a thorough history and examination.

It was my understanding that CN VII is a bundle of several nerves, one controls hearing, one controls balance, one controls facial sensation, and one controls muscles of the face. As it was explained to me, these all go through an aperature into the skull together, so it’s one big bundle of nerves. But I’m not a doctor, so consult a neurologist for accurate facts on nomenclature and function.

hastur, I tried to mail you but your profile doesn’t have an email address. Check my profile for my address and mail me and I’ll discuss it with you by email. I don’t like to describe the details of what happened to my particular condition on open internet boards, as it was sort of a worst case scenario. No sense in scaring the TM.

Cranial V controls facial sensation (including the inside of the mouth) as well as the “muscles of mastication” (chewing, jaw movement, jaw clenching).

Cranial VII controls the muscles of facial expression, taste on the front of the tongue, tearing and salivation, and a tiny muscle in the middle ear (stapedius).

Cranial VIII “controls” hearing and balance.

Despite their proximity to one and other, there are often distinct diseases and problems affecting each. An isolated problem of the Vth cranial nerve (or of facial sensation alone) merits the attention of a neurologist.

Ah, my mistake, I confused CN 5 and 7. Obviously these nerves can all have separate problems but since they run together through either the cavernous sinus or the internal auditory canal, some problems occur together, which is kinda why I asked the questions I did. I’m no neurosurgeon, but I was hoping to eliminate the possibility he had the condition I suffered from. It appears that this is eliminated, since my own problem was with CN 8 which affected the adjacent CN 7. But CN 5 does not follow this pathway AFAIK.

I’m not a doctor either, but I did stay at a Holiday Inn Express last night…

Seriously, is it possible you’ve had a mild stroke? In which case the MRI might reflect it.

Best of luck, and I’ll keep you in my prayers. Let us know what happens.

[More Nitpicks]

Well, the seventh cranial nerve does not run through the cavernous sinus at all. Two of three parts of the fifth nerve do, though.

Neither the fifth nor seventh nerves pass through the internal auditory canal. As mentioned, 2 of the 3 branches of CN5 do travel along the cavernous sinus, and the other through the superior orbital fissure. The seventh exits the skull via the stylomastoid foramen. I don’t see how the internal auditory canal relates to CN5 or CN7.

[/More Nitpicks]

I am not impressed with the accuracy of your posts in this thread.

Hastur: e-mail me if you like.

Yes of course, as I obliquely alluded to, CN 7 goes through the internal auditory canal with CN 8. And I was deliberately oblique, as will become apparent.

Who said I was trying to impress anyone? I am just trying to eliminate the possibility of this poor fellow suffering the same poor treatment I received from a specific condition. I didn’t want to get into specifics, but if this fellow has an acoustic neuroma, I am quite expert in that particular condition, or perhaps I should say I am quite expert in the malpractice that can occur over this condition, since I suffered a horribly bad outcome at what is supposedly the #1 otolaryngology/neurosurgery department in the US. I am sure my previous statements are now more clear (except perhaps that question fishing for TMJ problems) and since you surely know the gravity of that condition, you can understand why I want to help this guy if his condition was similar to mine, and why I didn’t want to refer to this in anything but the most oblique terms. But it apparently isn’t his problem, so the issue is probably moot.

I’m not seeking to impress anyone with my meager medical knowledge (as you apparently are), I only have one desire. In the unlikely event that this poor fellow does suffer from an AN, I want to speak to him and desperately hope to dissuade him from a new “revolutionary” treatment I had which is a recipe for malpractice. I am sure you can support that goal even if I don’t correctly use the precise anatomical and neurological nomenclature (which is difficult to memorize even for doctors). So lighten up, and perhaps instead of pouncing on simple errors, you could provide some useful information on possible medical conditions via a public forum, in the hopes that others seeking this information might benefit. It is better to light a candle than curse the darkness and all that.

In doublechecking your post, now it is my turn to be unimpressed with YOUR accuracy.

To reiterate, CN 7 and 8 pass into the cranium through the same aperature known as the internal acoustic meatus (a/k/a internal auditory canal). Here is a diagram.

CN 8 is labeled vestibulocochlear nerve, and CN 7 is labeled Facial Nerve. You can verify these details by forwarding through the next few pages.

Not me. Were you?

No, I am not trying to impress anyone. But I would like to impress upon you what I said in my e-mail to you: “you should not offer advice on things you don’t know about, especially when it comes to a person’s health. They may believe you.”

Indeed. My first two posts in this thread were hardly deprecating to you and were stated in a neutral tone in attempt to establish some basic facts (a key purpose of this Board). Then, when you persisted in posting misinformation, I ventured that “the accuracy of your posts” did not impress me. No more.

Let’s drop this.

A simulpost.

Meatus is not the same as canal. You are wrong, can’t see that you’re wrong, and can’t admit that you’re wrong.

You think you’ve “caught” me (but haven’t) yet overlook the many outright errors and BS you posts.

All I am asking is that you don’t post health information if you don’t know what you’re talking about, no matter how well intentioned you are.

I’m using the same terminology as the American Neurotology Association

and other medical textbook authors

Or perhaps a dictionary would suffice

The internal auditory canal is the same thing as the internal acoustic meatus, I’ve just reviewed dozens of medical papers and anatomical diagrams and they use the term interchangably. If you have a problem with that nomenclature, you should take it up with those people, I am merely using their terms. If you have further problems with me, go take it to the pit, where there is a thread full of people who like to attack me even though it should be obvious that I have no intention of responding. Surely this is one of SDMB’s greatest moments.

Let us speak no more of this. We both want to help this fellow, perhaps I can help him from the perspective of a patient, I don’t know what perspective you can help him from since I don’t know your medical qualifications. I did not dispense medical advice, I clearly pointed him to qualified medical personnel, which is impossible to obtain through SDMB, so in that sense, neither of us can fully assist this guy. Perhaps I can even help him more, since I can offer support from the position of a patient, about the only thing that does work well over a text medium. Is it so hard to imagine that nonmedical people can be valuable to patients?

hastur, if you want to email me, feel free, I can give you a perspective on neurosurgery from the perspective of a patient, but nothing more. Consult your neurologist, but be skeptical and verify everything he says by doing your own research and getting a second opinion if he recommends surgery.

I have classical migraines (with neurological auras), and in the time around migraine I often get numbness of my lips, palate, chin and cheek on one side.

I don’t think this is what you have because for me it tends to come transiently and fleetingly over several days before the migraine. It’s not persistent. It also doesn’t cover my entire face at one time, but tends to be patchy. There are people with more persistent migraine auras. But the more persistent and steady it is, the less likely it would be related to a migraine I’d think.

I mention it mainly because no one has mentioned it as an outside possibility, and to suggest that it doesn’t necessarily have to be related to the cranial nerve.

I had Bell’s Palsy the summer I was 18. The oddest thing about it was the numb feeling. I noticed it first on my tongue (just the right hand side.) By the next morning the whole right side of my face was numb, and by that afternoon (after I had gone in to the emergency room) it was visibly droopy. For me, it lasted about three or four months before it was gone, and the right side of my face still is a little slack when I am very tired. It was very odd to eat, because I could taste just fine on the left side of my tongue, but it was like sawdust on the right. All texture, and absolutely no taste at all.