Numbness of the chin occurs against the background of trigeminal neuralgia, injuries and tumors. It is observed with osteochondrosis, migraine, herpes zoster, B12-deficiency anemia, mental disorders. The cause is established on the basis of data from an external examination, dental and neurological examination, radiography, MRI, CT, laboratory tests. Treatment for chin numbness includes anticonvulsants, NSAIDs, antihistamines, antibiotics, physical therapy, and surgery.
The main sign of neuralgia is painful paroxysms provoked by shaving, tension of mimic and chewing muscles, contact with wind, cold water and air. The involvement of the trigeminal nerve trunk is characterized by numbness of the entire half of the face, which develops in the chronic course of the pathology. Numbness of the chin is noted with an isolated lesion of the 3rd branch (n.mandibularis).
Along with a decrease in sensitivity in the chin area, there is numbness of the lower part of the cheek, lower lip, lower jaw zone, buccal mucosa, gums, teeth, lower half of the tongue and oral cavity. The clinical picture is complemented by peripheral paralysis of the masticatory muscles, accompanied by facial asymmetry. Possible deviation of the lower jaw in the direction of the lesion.
In 95% of cases, neuralgia develops as a result of nerve compression. The cause of compression can be a change in the diameter of the adjacent vessel in arterial hypertension and cerebral atherosclerosis. Another provoking factor is tumors of the brain and bones of the skull. Sometimes the disease is provoked by narrowing of the bone channels due to chronic ENT diseases, traumatic brain injuries or dental pathologies.
Numbness of the chin during injuries is due to a violation of the integrity or compression of the mandibular nerve. Damage to the soft tissues of the face in the projection of small molars can lead to the onset of a symptom - in this place, a branch of the nerve emerges from the canal of the lower jaw, providing sensitivity to the chin and lower lip. With bruises and hematomas, compression is usually observed, the symptoms quickly disappear after the swelling decreases.
With open wounds, it is possible to cross the branch with long-term preservation of numbness. With a fracture of the lower jaw, compression or rupture of n. alveolaris inferior, located in the intraosseous canal. The injury is accompanied by pain, swelling, hemorrhages in the skin and mucous membranes, articulation disorders, facial asymmetry. Stepping of the dentition, mobility and dislocation of the teeth can be detected.
Fractures of the lower jaw
The infectious-inflammatory process develops as a result of diseases of the teeth and gums, purulent wounds, open fractures, boils and carbuncles of the face, some ENT diseases, and the spread of infection from distant foci. Accompanied by pain, fever, discharge of purulent contents from the gum pockets, restriction of mouth opening, respiratory disorders. Chin numbness may be associated with a tingling or crawling sensation.
Chin numbness is caused by cancer of the lower jaw. The occurrence of a symptom is often due to the germination of the nerve. The pathology is characterized by the early onset of pain, the rapid increase in pain to unbearable, the violation of the closing and opening of the teeth, infiltration of the cheeks and the floor of the mouth, ulceration, bleeding. Sometimes the symptom is provoked by some intraosseous or locally destructive benign neoplasias: ameloblastoma, osteoma, osteoblastoclastoma.
In some cases, numbness of the chin is caused by muscle tension and compression of the posterior roots of the spinal cord against the background of pathologies of the spine: osteochondrosis, protrusion, intervertebral hernia, spondyloarthrosis, etc. There are pains, a forced position of the head. Perhaps numbness of the upper limb on the side of the lesion.
One of the variants of the aura in migraine is transient sensory disturbances in the fingers with the spread of numbness to the entire limb, half of the neck, face and chin. Subsequently, a typical clinical picture of migraine is formed with pressing or throbbing pain in half of the head, slight dizziness, nausea, increased sensitivity to light and sound stimuli.
The disease develops against the background of the persistence of the herpes virus, is diagnosed in people who have had chicken pox in the past. Along with neuritis of the intercostal, facial and trigeminal nerves, skin rashes are observed along the course of the listed nerve trunks. In children, catarrh of the upper respiratory tract may be detected. Herpes zoster symptoms persist for 2-3 weeks.
Sometimes numbness of the chin is determined by the following pathologies:
The diagnosis is established by a neurologist. According to the indications, the patient is referred to a dentist, maxillofacial surgeon or hematologist. To clarify the cause of chin numbness, the following diagnostic procedures are performed:
Physiotherapy
Treatment tactics depend on the causes of chin numbness. Patients with trigeminal neuralgia are prescribed anticonvulsants. The dosage is gradually increased until a therapeutic effect is achieved. Reception is continued for several months, subsequently the dose is gradually reduced. The scheme is supplemented with antihistamines, antispasmodics, and means to improve microcirculation. According to the indications, blockades are performed. Among the physiotherapeutic methods, diadynamic currents, galvanization, ultraphonophoresis are effective.
To stop a migraine attack, NVPS is used, in severe cases, drugs from the triptan group are used. With repeated vomiting, antiemetics are used. To prevent paroxysms, long-term treatment with antidepressants and anticonvulsants is carried out. With herpes zoster, antiviral therapy with acyclovir is carried out. Mental disorders are corrected with the help of psychotherapy, sometimes in combination with psychotropic drugs.
Antibiotics are indicated for wounds, open fractures, osteomyelitis of the jaw. First, broad-spectrum antibacterial drugs are used, then the medication is replaced taking into account the antibiotic sensitivity of the pathogen. Patients with pernicious anemia need lifelong treatment with B12 drugs, elimination of the conditions that led to the development of beriberi.
The tactics of surgical intervention is determined by the cause of the symptom. The following methods are applied: