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What causes left-sided swelling in lip and tingling feeling in tongue?

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Posted on Tue, 12 May 2015
Question: my daughter is a nurse and she woke up yesterday morning with her lip swollen on her left side with tingling also on the left side of her tongue. she also said that her eyes were dry but her vision in her right eye was blurry. She is not taking any new medication & she says that her diet has not change in foods or drinks to cause an allergic reaction. I told her to take Benadril last night and it is worse this morning. She had discoid meniscus knee surgery in mid February at Mayo clinic & has been doing very well. Off pain meds and doing PT daily. I am concerned. She is going to see her regular physician today but they cannot see her till 1:45 which is 3 hours from now. Her nurse manager told her last night that she was concerned that is could possibly be Bells Palsey & then I mentioned this morning that I was concerned about Bells Paulsey but there is no drooping in her face. She mentioned that her fingers tingled a little bilaterally.
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Answered by Dr. Olsi Taka (23 minutes later)
Brief Answer:
Bell's palsy.

Detailed Answer:
I read your question carefully and I understand your concern. Thank you for including the photos, without them I wouldn't really have been able to answer.

Looking at the photos though it seems to me that this indeed a case of right side peripheral facial palsy (Bell palsy). In the photos there is an evident asymmetry of the face deviating towards the left (because the muscles on that side preserve their tonus and pull the face on that side). The fact that when attempting to close her eyes it is evident the muscle weakness involves the upper 1/3 of her face (another action to verify would be to raise her eyebrows, there should be less wrinkling or flatness on her right forehead) tells us it is a peripheral palsy, from the nerve, not from a brain lesion which would involve only the lower part of the face. Dryness of the eye is related to incomplete closure. Tingling phenomena are a common accompanying phenomena.

In the overwhelming part of these cases they are benign, often related to a virus. Young people have very good chances of fully recovering, especially as it doesn't seem to be a case of complete but only partial palsy. Therapy may include a course of prednisone for 10 days and acyclovir, an antiviral (since often is thought to be related to herpes infection), but they only aid the process her body will do most of the work.

However a physical exam is necessary. As I said most cases are benign but there are a small percentage of cases which could be related to a stroke, diabetes, infection etc. I consider it very unlikely considering her age, but a physical neurological exam is indicated to check for the potential presence of neurological signs which might warrant imaging and lab tests.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

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Practicing since :2004

Answered : 3668 Questions

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What causes left-sided swelling in lip and tingling feeling in tongue?

Brief Answer: Bell's palsy. Detailed Answer: I read your question carefully and I understand your concern. Thank you for including the photos, without them I wouldn't really have been able to answer. Looking at the photos though it seems to me that this indeed a case of right side peripheral facial palsy (Bell palsy). In the photos there is an evident asymmetry of the face deviating towards the left (because the muscles on that side preserve their tonus and pull the face on that side). The fact that when attempting to close her eyes it is evident the muscle weakness involves the upper 1/3 of her face (another action to verify would be to raise her eyebrows, there should be less wrinkling or flatness on her right forehead) tells us it is a peripheral palsy, from the nerve, not from a brain lesion which would involve only the lower part of the face. Dryness of the eye is related to incomplete closure. Tingling phenomena are a common accompanying phenomena. In the overwhelming part of these cases they are benign, often related to a virus. Young people have very good chances of fully recovering, especially as it doesn't seem to be a case of complete but only partial palsy. Therapy may include a course of prednisone for 10 days and acyclovir, an antiviral (since often is thought to be related to herpes infection), but they only aid the process her body will do most of the work. However a physical exam is necessary. As I said most cases are benign but there are a small percentage of cases which could be related to a stroke, diabetes, infection etc. I consider it very unlikely considering her age, but a physical neurological exam is indicated to check for the potential presence of neurological signs which might warrant imaging and lab tests. I hope to have been of help.