Anyone who has experience numbness of the face can attest to the panic that ensues. Causes include Bell's Palsy, nerve inflammation and stroke.
The facial sensation is provided by the trigeminal nerve and its three main branches. This nerve provides sensation and coordinates the control of facial muscles and expressions as directed by the brain. The trigeminal nerve arises from the base of the brain and passes deep inside the skull until it reaches the face. Loss of normal feeling and sensation is a common symptom of face numbness. Some report a tingling or burning sensation of a specific part of the face and even the lip. Loss of control is a sign of severe nerve involvement. Swelling may occur due to infection or tumors. Numbness may affect one or both sides of the face depending on the cause. Failure of the nerve to work properly results in paralysis and drooping of the face. These symptoms can be temporary or permanent.
Causes of Numbness in Face
1. Improper Position
General Information. Sleeping or performing activities with the head in an abnormal position can generate pressure and inflammation of the trigeminal nerve. Fortunately numbness in these cases is short lived.
Symptoms. Numbness and weakness of the affected side of the face as a consequence of the facial nerve impairment. Pain may result due to holding the head in an abnormal position for an extended period of time while reading or working on a computer. Sleeping in an awkward position can also produce the same symptoms.
2. Mild Stroke
General Information. Strokes are caused by blockage of blood flow to a portion of the brain. This can produce weakness or paralysis on one side of the face and body. Strokes are serious and demand immediate medical attention. Some strokes result in bleeding into the brain and are life threatening and may require emergency surgery.
Symptoms. Most people will note numbness and weakness on one side of the body or face. Stroke symptoms may start as mild tingling and then rapidly progress to full-blown paralysis of one side of the body. Facial drooping is common in strokes. Depending on what part of the brain is affected, speech and the ability to recognize people and objects may be impaired. Some people loose the ability to walk. A stroke generally causes permanent deficits, but may improve with time and therapy.
3. Transient Ischemic Attack
General Information. Transient Ischemic Attacks (TIA) are part of the evolution of a stroke. TIA symptoms resolve for most within in an hour. In the past 24 hours was the cutoff, but with advance MRI imaging it is apparent that permanent damage has already occurred. Once that has happened, the diagnosis is now termed stroke or cerebral vascular accident (CVA). The underlying problem is the same and due to blockage of blood flow to specific parts of the brain. Any person experiencing a TIA must seek immediate medical attention. Risk factors for a TIA progressing to a full-blown stroke include high blood pressure, duration of symptoms (>1 hour), diabetes, high cholesterol and advanced age.
Symptoms. The initial symptoms are the same as for stroke and include numbness, weakness, possible speech or balance problems, drooping of the face and weakness.
4. Bell's Palsy
General Information. Bell's Palsy results in paralysis on one side of the face. Rare cases involve both sides and are usually related to an infection from a tick bite (Lyme disease). Some experts believe Bell's Palsy is caused by a viral infection such as herpes. Every year one in 5,000 suffers an attack of Bell's Palsy.
Symptoms. Facial numbness and drooping is the hallmark symptom of Bell's Palsy. The entire side of the face is generally affected from the forehead down to the mouth. This is an important distinction as strokes or TIA attacks often spare the forehead. Twitching can occur of the facial muscles. Other common findings include drooping of the eyelids and mouth, drooling, abnormal sensation of the face and tongue and a change in taste perception. Most cases of Bell's Palsy resolve over time and improve with prescription drug therapies to decrease inflammation and fight infection.
5. Trigeminal Neuralgia
General Information. This condition can be caused by inflammation or irritation of the trigeminal nerve. Causes include abnormal blood vessel growth around the nerve, tumors and inflammation.
Symptoms. Severe shock-like pain is the hallmark of this condition. Pain can also be felt when shaving or brushing. Others may experience numbness or a burning sensation on one side of the face. The pain can be unbearable at times and most patients require specific medications to control symptoms or surgery to relieve pressure on the nerve.
6. Multiple Sclerosis
General Information. In this autoimmune condition, the body attacks various parts of the nervous system including the trigeminal nerve. The exact cause is unknown. Multiple Sclerosis can range from mild to severe in symptoms and can substantially impact the function and quality of life.
Symptoms. Numbness is one of the most common symptoms of this disease. Facial pain, double or blurred vision, pain in and behind the eye and numbness of the extremities can all occur due to MS. The course of progression is highly variable as some individuals only experience occasional mild symptoms, while others have progressive disease that results in complete disability.
7. Pinched Nerve
General Information. The facial nerve splits off into three separate branches to provide sensation for the entire face. The nerve branches can be compressed and pinched due to injury, irritation or trauma. This condition usually resolves spontaneously with time and rest.
Symptoms. Numbness and tingling one side of the face or a specific part of the face related to the pinched nerve. Sharp pain may result from compression or irritation of the nerve.
8. Facial Shingles
General Information. Shingles is a reactivation of a previous viral infection. The same virus that causes Chickenpox results in shingles. After the initial outbreak of Chickenpox (Varicella), the virus retreats back into nerve bundles called ganglia. During periods of stress or illness, the virus can reactivate and reappear as shingles.
Symptoms. Shingles results in numbness and burning often before the appearance of the rash. The rash becomes painful and appears as red blisters on a specific region of the body where the virus has become reactivated. Facial shingles can involve any part of the face and can also affect the eye. Vision can be impaired and for this reason, anyone with shingles on their face should consult a doctor.
9. Neuropathy
General Information. Injury to nerves of the face, neck or head can result in numbness and tingling of the face. Diabetes is one of the most common causes of neuropathy and is also a risk factor for a stroke. Diabetic patients experiencing facial numbness need to seek immediate medical attention.
Symptoms. Numbness of the face, burning or a pins-and-needle sensation, facial weakness or pain can all result from neuropathy.
10. Cancerous Tumors
General Information. All nerves are encased in a protective covering called myelin. Think of myelin as the insulation around an extension cord that keeps it from shorting out. Cancerous tumors can arise from this myelin sheath and cause compression and irritation of the facial nerve. These tumors usually progress slowly and require medical or surgical treatment. Other cancers that have spread from other parts of the body can also result in facial nerve compression and facial numbness.
Symptoms. Common symptoms include a gradual onset and worsening of facial numbness and often weakness. Pain may develop as the tumor grows in size. The majority of these tumors will require a multi-specialty approach to treat and include a general physician, surgeon and an oncologist.
11. Vitamin Deficiency
Vitamin deficiencies can result in numbness and B12 deficiency is the most common. This can result form stomach surgery, improper diet and is common in alcoholics. Symptoms include numbness and burning. Replacement of vitamin B12 generally resolves the symptoms.
12. Other Causes
A variety of other conditions can result in facial numbness and include: anxiety and depression, stress, panic attacks, hyperventilation, migraines and certain prescription or illicit drugs. Autoimmune diseases, in addition to MS, such as Sjogren's disease, scleroderma and systemic lupus erythematosus can all cause numbness and tingling of the face.
It can be very difficult for a non-medically trained person to accurately determine the cause of their symptoms. Even doctors at times are puzzled by the cause of facial numbness and additional specialized tests are required.
Immediate medical care is required whenever facial numbness is accompanied by weakness or numbness of one side of the body. Call 911 without delay. Certain types of strokes and other life threatening conditions can result in passing out or a change in behavior. The worst headache of your life can be a sign of a bleeding stroke or rupture of a blood vessel (aneurysm) and time is critical. Seek immediate medical attention. Call 911 for an ambulance to transport rapidly to the hospital.