Facial numbness is observed in neurological, dental, vascular and oncological diseases, traumatic injuries. It is less often detected in patients with mental disorders, infections, parasitosis, and some other pathologies. Most often unilateral. It can be temporary or permanent, covering the entire half of the face or a specific area. The cause of the condition is established according to the survey, external, neurological and dental examination, imaging and laboratory techniques. Treatment includes neuroprotective agents, anticonvulsants, antibacterial agents, and physiotherapy.
Short-term numbness of the face after waking up may be due to an uncomfortable position during sleep. In some people, a symptom occurs as a reaction to a stressful situation, strong feelings, alcohol intake, a number of medications. Sometimes a short decrease in sensitivity is observed when smoking, especially in the case of a return to a bad habit after a long break or with nicotine abuse.
The clinical picture of neuralgia is dominated by pain attacks, consisting of a series of pain impulses that go from the side surface to the center of the face, resembling a backache or electric shock. Numbness occurs with a long course of the disease, due to the loss of the functions of the trigeminal nerve.
If the nerve is damaged before it divides into branches, the sensitivity decreases on the entire half of the face. Involvement of the 1st branch is manifested by numbness of the forehead, upper eyelid, half of the back of the nose. With the defeat of the 2nd branch, the sensitivity of the infraorbital region, the side of the face, and the upper lip is disturbed. Involvement of the 3rd branch is characterized by numbness of the lower part of the cheek, lower lip, and chin.
The most serious cause of facial numbness associated with circulatory disorders in the brain is a stroke. The symptom occurs suddenly, combined with numbness, weakness of half of the body, speech disorders. A distortion of the face is revealed: the nasolabial fold is smoothed, the corner of the mouth is lowered. Headaches, dizziness, nausea, vomiting, disorders of consciousness are possible. Hemorrhagic stroke, as a rule, develops rapidly, ischemic - a little slower.
A similar picture can be observed with a transient cerebrovascular accident, but in this case, the symptoms persist for several minutes or hours, all manifestations disappear within a day. Numbness of the face is found in both variants of MI - transient ischemic attack (TIA) and hypertensive cerebral crisis.
The cause of transient circulatory disorders can be vertebrobasilar insufficiency. The symptom is more pronounced in the acute form of VBN, which develops within 1-2 minutes. Numbness of the face completely disappears after the attack ends. Violation of sensitivity often becomes the first symptom of TIA against the background of occlusion of the carotid arteries, combined with weakness of the hand, visual disturbances.
Facial numbness
Facial numbness sometimes accompanies migraine attacks. It can appear both at the height of the headache, and during the period of the aura. In some cases, the symptom is observed as part of the aura, including a transient decrease in vision and hearing, flickering flies, intolerance to loud sounds and bright light, but does not end with a pain attack. With cluster headaches, an excruciating pain syndrome occurs in the forehead, radiates to the eye, and is combined with severe facial numbness.
Numbness of the face can be detected in the following pathologies:
In benign and malignant brain tumors, numbness occurs due to compression of the region of the posterior central gyrus. In addition, numbness of half of the face is noted with neoplasms localized in the region of the pons or Gasser node. In dental practice, the cause of the symptom is compression or germination of the branches of the trigeminal nerve by the following neoplasms:
Facial numbness is also observed in neuroendocrine neoplasias of various localizations. The symptom appears during an attack due to the hormonal activity of the tumor, combined with redness of the face, a feeling of heat or burning.
Loss of sensation in traumatic injuries is associated with compression or mechanical damage to the branches of the trigeminal nerve. After compression, the symptom disappears within a few days, after a violation of the integrity of the nerve, a long recovery is required. After severe injuries, numbness sometimes persists throughout life. Violation of sensitivity can be caused by the following traumatic injuries:
The same mechanism is observed in arthrosis of the TMJ, osteomyelitis of the zygomatic bone, upper or lower jaw. The branches of the trigeminal nerve are compressed by edematous soft tissues or deformed bone, fall into the area of purulent fusion, which leads to a loss of sensitivity in the corresponding zone.
Among the possible etiofactors of facial numbness are diseases of the following groups:
The cause of facial numbness is established by a neurologist. According to the indications, a consultation of the maxillofacial surgeon is appointed. The specialist interviews the patient, establishes the circumstances, the time of occurrence, the rate of development of the symptom. Identifies other manifestations of the disease. Performs external and neurological examinations. The examination program provides for the following diagnostic procedures:
Acupuncture for facial numbness
A patient with suspected TBI or stroke should be positioned so that vomiting does not allow stomach contents to enter the respiratory tract. You need to unbutton your clothes to make breathing easier. In case of violations of breathing and cardiac activity, artificial respiration, chest compressions may be necessary.
Patients with epilepsy are laid on their side, a stick or spoon is inserted into the mouth to prevent damage to the tongue. All pathologies accompanied by a pronounced deterioration in the general condition, impaired consciousness, sudden loss of sensation or muscle weakness should be considered as a reason for the immediate call of the ambulance team.
The treatment regimen for conditions accompanied by facial numbness may include the appointment of drugs from the following groups:
According to indications, restorative measures are carried out, physiotherapeutic methods are prescribed: diadynamic currents, ultraphonophoresis, galvanization, electromyostimulation. Massage, reflexology, mechanotherapy, exercise therapy are used.
With neuralgia of the trigeminal nerve, restoration of sensitivity is possible after microsurgical decompression. Other techniques (percutaneous radiofrequency destruction, stereotaxic operations) eliminate the pain syndrome, but do not provide restoration of sensitivity. Taking into account the characteristics of other pathologies that provoked facial numbness, the following surgical interventions are performed: