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Suggest Treatment For Tingling Sensation In Face And Pressure In Chest

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Posted on Fri, 3 Jul 2015
Question: My 31 year old son has occasional tingling on the left side of his face, burning on left ear and neck, and pressure on left side of chest. Clear chest X-ray and clear brain MRI. We are thinking maybe shingles but no rash. Symptoms intermittent for 6 months. Sometimes swollen lymph nodes.
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Answered by Dr. Olsi Taka (48 minutes later)
Brief Answer:
Infection or inflammatory autoimune conditions should be considered.

Detailed Answer:
I read your question carefully and I understand your concern.

The doctor can not really be blamed as those symptoms are a little puzzling. As you yourself said shingles is unlikely due to lack of rash, widespread distribution and prolonged intermittent nature.
A brain MRI would have identified a brain lesion, cranial nerve compression, a dental or ear issue as a cause of those symptoms and these last options would not explain chest pressure anyway.
Considering the swollen lymph nodes, one direction to be looked at would be inflammatory or infectious conditions like tuberculosis, lupus, rheumatoid arthritis, lymphomas, conditions which could associate those abnormal sensations due to involvement of cranial nerves with lymph node swelling.
I still don't consider them very likely as some change should have been present on MRI, but some blood tests in that direction should be done (perhaps have been done already).
I would also consider the possibility of anxiety as the cause of those abnormal sensations on the face and chest, actually would be my first suggestion had it not been for the lymph node issue which is not typical.

I remain at your disposal for further questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

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Suggest Treatment For Tingling Sensation In Face And Pressure In Chest

Brief Answer: Infection or inflammatory autoimune conditions should be considered. Detailed Answer: I read your question carefully and I understand your concern. The doctor can not really be blamed as those symptoms are a little puzzling. As you yourself said shingles is unlikely due to lack of rash, widespread distribution and prolonged intermittent nature. A brain MRI would have identified a brain lesion, cranial nerve compression, a dental or ear issue as a cause of those symptoms and these last options would not explain chest pressure anyway. Considering the swollen lymph nodes, one direction to be looked at would be inflammatory or infectious conditions like tuberculosis, lupus, rheumatoid arthritis, lymphomas, conditions which could associate those abnormal sensations due to involvement of cranial nerves with lymph node swelling. I still don't consider them very likely as some change should have been present on MRI, but some blood tests in that direction should be done (perhaps have been done already). I would also consider the possibility of anxiety as the cause of those abnormal sensations on the face and chest, actually would be my first suggestion had it not been for the lymph node issue which is not typical. I remain at your disposal for further questions.