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Treatment for varicella zoster virus - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Infections
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1698 Questions
User :   would a stroke cause just numbness in the right side corner of my mouth and tongue??
Doctor :   Hi,
User :   hi
Doctor :   Stroke is an acute emergency
User :   can a stoke do what I just asked
Doctor :   presenting with weakness and numbness of the whole one side or both sides of the body
Doctor :   no,
Doctor :   Stoke do not cause numbness of the face alone
User :   yeah this is just far right side of my tongue and rite in the corner of the right side of my mouth but no where else
Doctor :   then it can never be due to stroke
Doctor :   it might be due to local nerve weakness
User :   could it be from TMJ
Doctor :   less likely
Doctor :   or even not a chance at all
User :   what kind of nerve weakness do you think
Doctor :   Peripheral nerve weakness , due to cynacobalamine deficiency , which do commonly present this way
Doctor :   Cynacobalamine ( Vit B 12 )
User :   my b12 was high when it was checked 4 months ago so I doubt thats what it is, but can severe anxiety or stress cause this
Doctor :   yes, stress can be a cause , where the symptom can be classed as psychosomatic
Doctor :   May i know the value of the Vit B12 checked last time
Doctor :   ?
User :   1826
User :   LOL
User :   it was high
Doctor :   ok, was it 1826 pg/ml ?
User :   yes
Doctor :   ok,
Doctor :   Is there any facial weakness
User :   does not appear to be
Doctor :   ok,
Doctor :   Did you ever had oral herpes ?
User :   should I be worried
User :   yes in the past
Doctor :   you have to be examined for herpes zoster
Doctor :   as the past herpes simplex can emerge as zoster with such neural symptoms
Doctor :   and it commonly affects the 3rd cranial nerve which is the sensory supply of the face
User :   are u talking about shingles
Doctor :   no , shingles is due to pox virus
User :   what is herpes zoster
Doctor :   I was asking about herpes simplex infection
Doctor :   which presents with vesicular ( water filled lesions) in the oral mucosa
Doctor :   which after cured after some years present as zoster lesions ( shingles ) or neuronal weakness
User :   yeah I know what they are I have had them but this feels different, no tingling at all or pain, part of my corner of my mouth and part of my tongue feel like I have been to the dentist and been numbed up and its wearing off
Doctor :   shingles are caused by various viruses like Varicella zoster ( pox virus ) and some times by herpes zoster
User :   but you are sure its not a stroke
Doctor :   ys, i am sure of it
Doctor :   but the stress related issue can also not be ruled out
Doctor :   and i also advice you to get the vit B12 test again if the test is more than 6 months old
User :   does it mean something bad if it is still high, or do you know why it might have been high
Doctor :   no , the higher levels are not dangerous ( till > 2500pg/ml )
User :   ok
Doctor :   and the major cause of its blood levels being high are the failure of the liver to hold the Vit B12 as the store or you may be on Vit B12 supplement that time
Doctor :   Major part of the bodys Vit B12 is stored in the liver
User :   I do drink alot of ensure shakes and they have a lot of B vitamins in them
Doctor :   ok, may that be the reason here
Doctor :   i would suggest you to get your self tested for the vit B12 levels again , and also consult a dentitist to rule out TMJ
User :   I already know I have TMJ thats why I asked you if it could cause this
Doctor :   it could be a rare cause , if its due to TMJ there would be weakness of the mastication muscles ,
Doctor :   its rarely only sensory ,
Doctor :   always presents with motor and sensory symptoms
Doctor :   hence a examination to check the motor component of the Third cranial nerve is important to rule out TMJ disorder effect
User :   ok I will
Doctor :   and it its due to TMJ then its self limiting , and goes off in time
Doctor :   but if due to Vit defeciency , vitamin ( injectable vit B12 ) supplementation is a must
User :   ok I'll get all that checked then, thank you for your help
Doctor :   you are welcome
User :   bye bye
Doctor :   Thanks for consulting me , bye for now
Doctor :   Take care
Doctor :   wish you good health
User :   thank you
User :   you too
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