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Forum Name: Neurology Topics

Question: 2-year Facial Weakness--Trifacial Nerve?


 rvanwag - Thu Mar 26, 2009 11:08 am

For the past two years, my face has abnormally tight and weak. Each morning and several times throughout the day, I stretch out my face (through literally putting my fingers in my mouth and stretching) to be able to communicate and express myself somewhat normally. It's nothing debilitating, but it has affected my ability to smile and talk like I used to. It has become extremely frustrating, especially since I am currently a business student and have many opportunities to network with professionals. I've been to many physicians, including a Neurologist, but nothing has provided relief (except for minor relief from Ibuprofen).

The only time in the last two years that this has completely gone away was when I got a root canal a couple months ago. I assume it was the shot of Dexamethasone and that it was close enough to the trifacial nerve to somehow make a difference (perhaps reduce some swelling in the region). For about three days after the root canal, the weakness just dissolved away and I was finally able to truly be myself. Unfortunately, after this effect wore off, my facial weakness returned.

I'm wondering if you have any ideas as to what this might be. At this point, I'm open for anything.

Thanks,

Ryan
 John Kenyon, CNA - Sat Mar 28, 2009 9:51 pm

User avatar Hi Ryan,

Since you've seen a neurologist, did he (or she) have you help test the nerve via performing (or attempting) facial movements such as frowning, puffing your cheeks or pursing the lipe and puffing? This sounds very much like Bell's palsy, which is a virally mediated inflammation of the facial nerve, especially the five major facial branches of VII cranial nerve and could cause this sort of problem. Also, did this appear spontaneously or insidiously?

Oddly, pseudo-Bell's palsy is often caused by in innacurrately place injection of local anesthetic by injection in the dentist's office, so your experience is almost paradoxical in that respect, but could provide a useful clue to a neurologist. It's clearly a neurological problem, certainly involves some branch or branches of the VII cranial nerve (the various parts that constitute the trifacial branch) and a neurologist should be able to at least diagnose if not cure this (although Bell's palsy usually does resolve on its own, I have seen a few cases with very long residual periods).

It will keep coming back to a neurological workup, because that's where it belongs. If your neurologist hasn't been helpful you may need to find a different doctor who is more interested. This can't be any fun, and it's gone on for quite a long time now.

I hope this is of some help to you. Good luck and please follow up with us here as needed.

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