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Is Facial Numbness Symptom Of Trigeminal Neuralgia?

Posted on Wed, 6 Aug 2014

Question: I had facial numbness on my rt side,now the numbness has transfered to my lt side,more around my mouth area. My MRI showed enhancement of my trigeminals. WBC in my spinal fluid was 55. A doctor think I have Trigeminal Neuralgia and started me on Neurontin. Been on Neurontin for three days, nothing has changed since. Is it too early for a result? My mouth feels numb when the wind hits my face, my mouth tastes funny.

Answered by Dr. Naveen Kumar Nanjasetty (34 minutes later)

Brief Answer:
I doubt neuralgia...

Detailed Answer:
Hi

Thanks for posting the query.

After going through the history, I do understand that there is some compression of the trigeminal nerve, which is the main cause of the numbness.

Trigeminal neuralgia causes burning sensation over the affected area but not numbness. Hence, neurotin is not effective for you.

You need to take oral steroids with vitamin B 12 to help in regeneration of the nerve. Also, consult a good neurologist or ENT specialist for a complete examination and review of the scan.

Hope I have answered your query; I'll be available for the follow up queries.

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Naveen Kumar Nanjasetty (7 hours later)

Do you have any idea what can cause enhancement of the trigeminal nerve? I had my braces( dental) removed , had my teeth clean and had tetanus shot all done on May 29th. My problems started on XXXXXXX 10th. Do you think there's any connection? Will prednisone be a steroid of choice? My neurologist wants me to repeat my MRI and Lumbar puncture and these tests cost money.

Answered by Dr. Naveen Kumar Nanjasetty (3 hours later)

Brief Answer:
You may have to repeat MRI scan

Detailed Answer:
Hi

Welcome back

1. Few causes of swelling of trigeminal nerve neuropathy are:
a. Ischemia (eg, brain or spinal cord infarction, vasculitis)
b. Demyelinating disorders
c. Nerve compression (eg, by tumors or a herniated disk)
d. Metabolic disorders (eg, diabetes, thiamine or vitamin B12 deficiency)
e. Immune-mediated disorders
f. Degenerative disorders (eg, hereditary neuropathies)

2. In a neuropathic condition or edema of the nerves, the initial treatment is with steroids along with treatment of the cause. Oral prednisolone is the commonest steroid prescribed.

3. MRI and CT scan of the brain both are required to diagnose the cause. Hence, repeat MRI scan is required to compare with the previous scan to look for any pathology.

4. If no significant abnormalities are noted in these scans; it will be presumed to be of idiopathic in origin and treated with steroids accordingly.

Hope this information was beneficial to you.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Prasad