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Forum Name: Neurology Topics

Question: Unexplained facial numbing; clean tests, but silent doctor?


 kitkatclub - Sat Aug 18, 2007 5:24 pm

Thanks in advance for anyone who wants to take a crack at this and shed some light on my problem!

I am female, 33, and have a warm sensation on my right temple, as if it has been shot with novocaine. A few hours later I felt some numbness in the right arm, and went to the hospital. My attending assumed immediately that I had a TIA or stroke, but the facial numbness did not go away after 24 hours and has remained for 5 days. Additionally (I have now had time to read about TIA/stroke), I never lost any muscle function, never had blurred vision, loss of consciousness, loss of strength, no drooping of one side, etc. Of course, I'm no doctor, but it doesn't seem like the symptoms match up with TIA or stroke.

No past surgeries. I have previously had bronchitis stemming from an allergy, and a kidney stone. On my father's side there is some history of high blood pressure and heart attack, but only after age 55. My grandparents died of heart attacks in their 70s, but also had poor diets. No other history of diabetes, stroke, heart disease.

I got a battery of tests, from a CT, a MRI of my brain and neck, an ultrasound of my heart and the arteries in my neck, and a bunch of blood tests. Apparently all my tests came back normal, which should rule out a TIA or stroke... but I actually wasn't told anything one way or another during discharge.

Bluntly, it looks like there may have been some kind of dispute between my attending and the neurologist over the tests that were ordered. (Going on something the attending said to me.) I was discharged with instructions to continue taking an aspirin a day, and no other information than "your charts are clean."

I have not been able to reach the treating neurologist on the phone. The discharge papers had no information, and the nurse informed me that I "couldn't talk" to the neurologist again without a referral from my HMO. Except, I have a fantastic PPO and every service I got was already within network?! It does appear that there was a paperwork misunderstanding -- I only care that I'm not being given a straight answer about the continued numbness.

So, it looks like I need both some information about what could be causing the continual facial numbness, and advice about what to ask/learn about when picking a new (outpatient) neurologist!

I have previous ulnar damage to this arm from trauma several years ago (including a hairline fracture of my wrist), and since I am a heavy computer user, believe it could be repetitive stress in the arm causing the numbness.

Besides a sinus infection or Bells palsy, what else would cause this kind of facial numbing, and not show up on an MRI, CT scan or arterial ultrasound? Are we correct in assuming that this was not a TIA or stroke, but probably something else? As you might imagine, my parents and I have been worried sick.
 Dr. Chan Lowe - Thu Sep 06, 2007 2:09 pm

User avatar Hi Kitkatclub,

I do think it is unlikely that you had a TIA or stroke. By definition, TIA symptoms should resolve within 24 hours.

I wonder if you may have some nerve compression causing your numbness.

Seeing a neurologist is important. They may want to order and EMG study. This is a study where they look at the response of the nerves/muscles to stimulus and see if it is normal. It can be very helpful in determining if there is a nerve problem or not.

Really, any neurologist should be able to help figure this out for you. I would recommend you ask your primary doctor if there is a particular neurologist in town that they recommend.

Best wishes.

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