facial numbness

[Karen]

I had my surgery 8 years ago with facialpaaralysis dry eye deaf inone ear and facial numbness.  Does  anyone else  have facial numbness


Lately my face is feeling all tight and uncomfortable  I had a MRI a year ago and everything was ok.  How can you   tell if something  is wrong if you don't have feeling   Right now it feels like I've been to the dentist and full of novacane.e

[mindyandy]

Hi Karen
I have some facial numbness from my surgery 3 months ago. I had some numbness around my mouth before surgery. My trigeminal nerve was involved. This is what causes facial numbness. I'm not sure if you had any treatment but your AN could be touching your TN.

Mindy

[LizAN]

Wouldn't the AN have to be protruding from the IAC to touch the trigeminal nerve?

I have had numbness on the side of my head above my affected ear, since the very beginning when I was first diagnosed in 2010.  At that time, my AN was fully contained within the IAC.  My ENT was confused by the numbness, because he also thought that the numbness could not be caused by the facial nerve.

My partner's anatomy textbook says that the facial nerve is a sensory as well as a motor nerve.  It seems odd to me that this would be an area of controversy.   

[mindyandy]

Liz
I'm not sure how to answer that question. I know that after my surgery Dr. Schwartz told me my Trigeminal nerve was close to my facial nerve. My AN was definately touching my TN. Maybe others will chime in who would have an answer.

[LizAN]

As I understand it, the trigeminal nerve and the facial nerve are relatively close together, once you get outside of the IAC, but the trigeminal doesn't run inside of the IAC like the facial nerve does.  I don't see how my original head numbness would have been caused by pressure on the trigeminal nerve, and even with my tumor starting to protrude from the IAC, I don't think it is yet touching the trigeminal.  I think facial numbness can also be caused by the facial nerve itself.

I suppose I should add this to my list of questions for Dr. Slattery.

[mindyandy]

Liz
That would be a great question to ask. I have pain before the numbness.

[hkelsch]

hi everyone! well, being a medical student, I can tell you that the facial nerve (cranial nerve 7) controls the muscles of facial movement, like closing the eye, smiling, puffing out the cheeks, raising the eyebrows, and pursing the lips. It also has some sensory fibers that help with taste. It runs with the vestibulocochlear nerve (cranial nerve through the IAC. The trigem (cranial nerve 5) controls the sensation of the face and controls the motor movements of mastication (chewing). It exits the brain stem very close to the facial n. ANs can be large enough or in a position to put pressure on the trigem in addition to the facial nerve.

I hope this helps from what your docs have told you!!

[reg]

 ???i to am expericiencing that, please let me know of any thing new or that you hear of.  you are not alone

[LizAN]

hi everyone! well, being a medical student, I can tell you that the facial nerve (cranial nerve 7) controls the muscles of facial movement, like closing the eye, smiling, puffing out the cheeks, raising the eyebrows, and pursing the lips. It also has some sensory fibers that help with taste. It runs with the vestibulocochlear nerve (cranial nerve through the IAC. The trigem (cranial nerve 5) controls the sensation of the face and controls the motor movements of mastication (chewing). It exits the brain stem very close to the facial n. ANs can be large enough or in a position to put pressure on the trigem in addition to the facial nerve.

I hope this helps from what your docs have told you!!

hkelsch,

That is exactly what I have always heard, but it does not make sense of my experience.  I had numbness on the side of my head long before my tumor began to protrude from the IAC.  At this point, my tumor is only beginning to protrude, and the numbness has spread to my face.

The sensory fibers in the facial nerve are ONLY associated with taste?  No possibility of any skin or muscle sensation in the face itself?

Liz

[hkelsch]

LizAN,

well, I've been searching through my resources in the hopes that I can give you the best answer. As I understand it, the facial nerve only sends sensory to to tongue. "The trigeminal sensory complex is the sensory nucleus for all sensations from the face. All general somatic afferent (GSA) fibers from cranial nerves 5,7,9,10 terminate in some part of the trigeminal sensory nucleus, which includes three nuclei."

That's what my text says. So basically, it means that fibers from the facial n. end on the trigem sensory nucleus, which is a part of the brain that is essential to sensation of the entire face. The sensory nucleus spans almost the entire length of the brain stem, it's huge compared to all the other nuclei. General somatic afferent (GSA) fibers convey pain, temperature, and pressure but they are primarily conveyed by the trigem n. So if the facial nerve gets affected by the tumor, then those fibers from the facial n. that are carrying pain, temp, and pressure (not all of them) to the trigeminal sensory nucleus are affected too causing the numbness.

I really hope this helps, I'm not trying to confuse anyone more.

[LizAN]

LizAN,

well, I've been searching through my resources in the hopes that I can give you the best answer. As I understand it, the facial nerve only sends sensory to to tongue. "The trigeminal sensory complex is the sensory nucleus for all sensations from the face. All general somatic afferent (GSA) fibers from cranial nerves 5,7,9,10 terminate in some part of the trigeminal sensory nucleus, which includes three nuclei."

That's what my text says. So basically, it means that fibers from the facial n. end on the trigem sensory nucleus, which is a part of the brain that is essential to sensation of the entire face. The sensory nucleus spans almost the entire length of the brain stem, it's huge compared to all the other nuclei. General somatic afferent (GSA) fibers convey pain, temperature, and pressure but they are primarily conveyed by the trigem n. So if the facial nerve gets affected by the tumor, then those fibers from the facial n. that are carrying pain, temp, and pressure (not all of them) to the trigeminal sensory nucleus are affected too causing the numbness.

I really hope this helps, I'm not trying to confuse anyone more.

Thanks so much for trying to help me understand this.  I've read it several times and am still struggling with the meaning.  Does this mean that pressure on my facial nerve might be causing numbness on my face?  It sounds like all of the cranial nerves send some impulses to the trigeminal sensory nucleus, not just the trigeminal nerve.

Liz

[hkelsch]

Hi Liz,

i'm sorry for making this confusing. basically what it boils down to is that the trigem controls the sensation of the face. the AN just grows large enough that it pushes out pushing on other structures or causing other structures to push on the trigem. there's not much room in there and the trigem is pretty big compared to all the other cranial nerves. Do you mean you actually can't feel one side of your face, or you just can't move it? For me, I can feel everything, but I can't move it.

[mindyandy]

I have facial movement. What I feel is numbness. Like you would feel a few hours after you left the dental office. My numbness has gotten WAY better but still there. I will take numbness over trigeminal neuralgia ANYDAY. That is awful pain.

[LizAN]

I have full movement, pre-surgery.  My face isn't totally numb, it is just tingly in places, but only on the AN side. It started on the side of my head, when I was first diagnosed with a tiny tumor that was completely inside the IAC.  It has spread to the top and back of my head and is now coming across my cheek.  My tumor should be  nowhere near my trigeminal nerve yet.

[hkelsch]

wow, i guess i didn't realize that you could have movement but no feeling. weird. I guess i'd rather my face move like you!

mindyandy, i see that you had treatment done in seattle. are you from there? i'm originally from spokane and had gamma knife done there!

liz, my face is tingly as well so i know what you mean there. The trigem has three branches, the opthalmic, maxillary, and mandibular. I looked it up on wikipedia and it seems like a pretty good reference.