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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes swelling in face post treatment for paralysis?

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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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Posted on Mon, 9 Nov 2015 in Thyroid Problem and Hormonal Problems
Question: In may this year, I woke up with the right side of my face swollen. I had some paralysis and was treated in hospital as a stroke but all tests came back negative. The swelling happened for 2 days afterwards similarly with symptoms resolving by the end of the day. The third day i awoke with weakness on left side that lasted 72 hours with full recovery. All CT's and MRI's negative. Final diagnosis was migraines. I am currently taking topamax 50mg daily. I have had 6 episodes of awakening with facial swelling since 9th September. I find it difficult to breath when looking down like my neck is blocking. I am not happy with my current diagnosis as I do not get headaches with the swelling.Could this be thyroid related.
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Answered by Dr. Shehzad Topiwala 5 hours later
Brief Answer:
Thyroid

Detailed Answer:
Swelling of the face is one of the signs of an under-active thyroid. The condition is called hypothyroidism.
A simple blood test for

TSH
Free T4

can effectively rule this out in most cases. It does not require fasting and can be done at any time of the day.

When I see someone like you in my practice, I also order the following tests in addition to a thorough physical examination :

CBC
HbA1c
Electrolytes
Glucose
Calcium
Kidney function tests
Liver function tests
25 hydroxy Vitamin D
Urine protein


If the urine protein is positive then 24 hour urine protein excretion will need to be measured.
This is because leaking of protein in urine can lower blood albumin levels which can result in swell in in the face and body.

I understand you have been hospitalised recently and the medical team may have already ran most, if not all, of these tests.



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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