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    Suggest treatment for facial nerve dysfunction

Posted on Tue, 9 Feb 2016 in Headache and Migraines
Question: Am awaiting the mri to evaluate my 6mo enlarged painless hard parotid left side, 46 yowf, now being told have an adjacent painless lymph gland very concerning to my rheumatologist she said it's not a stone. I have SLE - sjorgrens tests neg- should I be especially concerned about my increasing frequent periods of numbness and slight drooling on my RiGHT side? Old doc said face weaker on that side but I hadn't put it together with parotid. No visible drooping.
Answered by Dr. Erion Spaho 1 hour later
Brief Answer:
Facial muscles and nerves dysfunction due to mass effects.

Detailed Answer:
Hello and thanks for using HCM.

I have read your query and understand your concerns.

Painless unilateral parotid gland enlarged may be caused by several conditions ranging from sarcoidosis, autoimmune diseases to tumors of the gland that in majority of cases are benign and slow growing ones.

The condition will be clear after MRI of the gland and adjacent structures.

In your case, drooling can be related to partial dysfunction of a part of the facial nerve that pierces the parotid gland (even there is no visible dropping on that side),
but can be also related to muscles weakness due to Botox injections.

So, drooling can be explained by an impairment of coordination in facial muscles.

Numbness also is a neurologic sign that may be related to another cranial nerve compression ( Trigeminal ) by mass effect, but distribution (area affected ) of the numbness is necessary to be known in order to have a correct understanding of this issue.

An evaluation by a Neurologist is needed about drooling and facial numbness.

Treatment also should be considered and include s physical therapy of affected facial muscles and use of drugs to ease numbness such Gabapentin, Carbamazepine etc.

Use of vitamins B group preparations improves (at least partially) nerves function.

Hope you found the answer helpful.

I remain at your disposal for further questions and clarifications.


Above answer was peer-reviewed by : Dr. Sonia Raina
Follow up: Dr. Erion Spaho 2 hours later
Thank you - can the parotid lesion on the left cause drooling on the right?

Am hoping its from Botox or some mild Bell's palsy
Answered by Dr. Erion Spaho 3 hours later
Brief Answer:
Both, Botox and uncoordinated muscles are possible reasons.

Detailed Answer:
Welcome back.

Numbness in your right side isn't related to parotid gland lesion ( it could be also related to Botox injections side effects), drooling instead, could be an issue of uncoordinated facial muscles, but also it is very likely to be related to Botox injections adverse effects, if last injections were done on the right side.

As I mentioned before, an accurate neurological examination of nerves and muscles of head and face is needed to have a correct opinion about the diagnosis.

Hope I helped you.

Best regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
Answered by
Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 3852 Questions


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