Dr. Abhaya Kant Tewari
Neurology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have been experiencing numbness on the right side of my face, near my mouth and cheek, sometimes on my forehead in between eyebrows. I am not on any medication. I had a full neurological examination as part of a routine check up five months ago, and there was nothing abnormal. I do have a phobia with such symptoms, and I often visit the neurologist for reassurance.
Because of the pandemic, I am unable to do this. Since my last visit, I get worried as I suffer from anxiety when such symptoms come. A year ago, I had an MRI of my head, which was normal. I also had an EMG by the neurologist a year ago, and it was normal. I wanted to ask you if I should be worried about the numbness.
Hello,
Welcome to icliniq.com.
Let us analyze your symptoms. You have numbness on the right side of your face, mainly the mouth and cheek. Also, you have it on your forehead between the eyebrows. Now the nerve supply to the face is on each half by one sided nerve. If it is crossing the midline as it is on the forehead, the sensory component of the nerve supplying on both sides must be involved. Simultaneous involvement of both sided nerves is not likely at all.
There is no need to worry about these symptoms and relax as you investigated in the past. I do not think there is any need to worry. It may be anxiety acting up again. Try to relax, and do some exercises and a daily routine to fix this problem. In any case, not to worry about this. If there is any other doubt, feel free to contact me, we can think of prescribing some medication.
Patient's Query
Thank you doctor,
How often should I have an MRI or EMG? I have not seen my neurologist for three months, that is why I worry. I do not know how often we should visit to make sure all is fine. Almost one and a half years ago, I lost my mother, and a couple of months later, I started having muscle aches on my thighs, knees, shoulders, and neck. I did all investigations, but all were normal, from blood tests to MRI head, neck, EMG, etc. Then, in the end, one of the three neurologists I went to told me it might be fibromyalgia. I then went to a Rheumatologist who also suggested possible fibromyalgia.
I was in pain that lasted a few months, and then from spring to this autumn, it was much better, I thought it went. It has been a few weeks that I feel the same pain in the thighs and upper back. I am very stressed at the moment and have panic attacks. I have not seen my family for a year due to COVID-19, and I feel really low.
I wanted to ask you if fibromyalgia can cause these paresthesias on my face or anywhere in my body. How can I try to calm myself and stop thinking that there may be something wrong with me?
Hello,
Welcome back to icliniq.com.
I will again like to reassure you that you do not require any further investigations as yet, maybe even after a year. The investigation was done without a specific aim often lead to confusion and anxiety in the patient and the doctor's mind. The investigation should be done to clarify a clinical diagnosis and be focused on a particular question.
No, it is not fibromyalgia. The diagnosis is mild anxiety from which many persons are suffering due to the present conditions. You do not need to do any investigations. Perhaps discussing with your doctor once in a while is a better idea.
You should do some exercises, have a routine and try to follow some hobby which can be managed at this time like reading, walks, maybe try painting, improve your cooking skills, etc., or whatever you like. Do video calls with your friends and family as much as possible, build your relationships with family and friends a sure shot method for relieving anxiety. If all this does not work, there are medications for anxiety, but be rest assured you do not have fibromyalgia.
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