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Forum Name: Neurology Topics

Question: raised right brow / tightness above brow


 stugib - Wed Apr 01, 2009 4:36 am

Hello,

For quite a while now, perhaps a few years, I've had what I can only call a tight, nagging feeling on the right side of my forehead (just above my eyebrow). The effect of this sensation is to raise and crease my right brow, making the upper part of my face look strangely unsymmetrical . This makes me extremely self-conscious in social situations and I have to started to avoid having my picture taken (even though those closest to me say it is hardly noticeable - they are just being nice IMO!). At times the feeling is accompanied by a twitching of my right eye and a "coldness" in my lower right forehead. I have also noticed a slight aversion to daylight and a tendency to squint.

Some days, I should add, the feeling does not exist. At times I can go without it for days, only for it to return for several more days. It tends to be slightly worse when I am either tired, stressed or excited. However, at times I feel I am neither of these and it is still there.

I have been for both a CAT scan and MRI (head) and nothing was found. Then I thought it could be eye strain but the opthamologist reported no problems, suggesting that the lack of symmetry is probably a nerve problem. This is why I have decided to come to doctorslounge.

I hope you can help me here. I am almost positive it is nothing serious, but it also something I really wish would just go away.

Thanks
 John Kenyon, CNA - Mon May 18, 2009 10:03 pm

User avatar Hello --

This sign (ofeten referred to as the "other" Babinski's sign) is often seen in conjunction with inflammation or impingement of one of the cranial nerves, usually the trigeminal nerve. The good news in your case is that you aren't having trigeminal neuralgia, which causes excruciating scalp or facial pain, so the problem is probably farther downstream than it usually is. How this might have happened is debatable, and the only way to be certain is to have a neurological consult to try and find the location of the problem if this is bothering you sufficiently. Personally I would want to know anyway, since there is something going on and it isn't right. It may be stable and benign, but it also could be a signal of something more serious going on. I personally would want to know, aside from the fact this would probably drive me crazy. :)

If you've had any relatively recent trauma to the head that would probably explain the mechanism if not the actual cause. This is something surprisingly easy to miss or forget about, so give it some thought as to whether or not you've been struck on the head or had anything, however innocent-seeming, happen involving even a light blow to the head, face or neck.

I hope this is helpful. A neurologist should be consulted for a more complete idea of what may be going on. If it's innocent it still must be annoying and there may be a simple way of managing or resolving it. Good luck to you with this. Please follow up with us here as needed.
 stugib - Wed Jun 03, 2009 8:16 pm

Hi John, many thanks for your reply.

I took your advice and made an appointment to see a neurologist. I was diagnosed with partial hemifacial spasm and, besides that, the doctor told me pretty much what you had said in your post. He, too, was surprised that only my upper face (brow) was affected since usually the affected nerve also causes problems on the lower part of the face (mostly cheek). He also asked me if I had experienced any recent head trauma. I honestly do not think I have. I have never been unconscious and the only time I have taken a blow to the head is perhaps when making contact with a soccer ball with the wrong part of my head. However, the progression of my condition has been gradual. I certainly did not wake up with the condition one morning. He was also surprised that I experience no pain, merely a tingling senstation and discomfort.

Anyway, I was sent for a cerebral MRI, which came back all clear. I have been put on a 2-week course of Lioresal and Magne B6. He also advised me to massage my brow twice a day and exercise the nerves/muscles in my brow in front of the mirror for five minutes twice a day. He seems confident that this will work. If not, he has suggested a course of low-dose botulinum injections.

I am very glad that my condition has been diagnosed by a professional, and to have spoken to some people who understand exactly how annoying this thing is for me.

Please let me know if you think the medication I have been prescribed will have the required effect, or if you think there is anything else I can do in the meantime to alleviate the symptoms. Also, do you think stress has an effect on the affected nerves? If I am particualry tired or have a bad day at work the condition seems to be worse. Also, moderate alcohol consumption seems to make the symptoms disappear entirely. Is this normal? For me this is quite worrying as I do not want to increase my alcohol consumption as a means of alleviating the symptoms....however, it works like nothing else!

Many thanks,
Stu

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