Facial neurosis: symptoms and signs, why numbness of the facial muscles occurs, what is facial paresthesia, treatment

Often you can meet people with an interesting facial expression: it is asymmetrical, as if distorted, emotionless, perhaps accompanied by small muscle twitches.
All these signs are united by a common name - facial neurosis. This condition can have a different nature of occurrence and is provoked by both objective reasons and factors of a psychogenic nature.

Unusual sensations

It happens that a person can feel phenomena in the face and head that are unusual for the usual state. They are called paresthesias and are manifested by the following symptoms:

tingling;
burning;
"goosebumps"
numbness;
itching and rashes.

Often facial paresthesias have an organic basis and become a sign of the disease:

neuritis, neuralgia of the cranial nerves;
multiple sclerosis;
stroke and other circulatory disorders in the brain;
shingles;
migraine;
diabetes;
epilepsy;
hypertension.

In certain cases, unusual sensations are observed in certain parts of the face. For example, similar manifestations in the language may appear for the reasons listed above, but often have a different etiology. They are provoked by cancer of the tongue and larynx, as well as trauma by a splintered tooth or denture.

Dental procedures cause numbness and other unusual feelings, especially after tooth extraction. Another reason for their appearance may be an uncomfortable position during sleep or an unsuitable pillow. But the sensations caused by such phenomena usually pass soon.

Another group of provoking factors consists of psychogenic and neurogenic disorders.

Numbness of the face

Stroke

Diabetes

33415 March 16

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-treatment.
In case of pain or other exacerbation of the disease, diagnostic tests should be prescribed only by the attending physician. To make a diagnosis and properly prescribe treatment, you should contact your doctor. Numbness of the face: causes of occurrence, what diseases it occurs with, diagnosis and treatment methods.

Definition

Numbness of the face occurs when the sensitivity of skin and muscle receptors to various impulses is impaired. This symptom may develop gradually or appear suddenly. Loss of facial sensitivity is described as burning, tingling, sometimes pain, and in some cases as a complete absence of sensation. When the face is numb, the color of the skin over the affected area may change in the form of pallor or redness.

In severe cases, sensory impairment is accompanied by a decrease in the motor function of the facial muscles.
Types of facial numbness
Any external influence, be it heat or cold, light touch or strong pressure, leads to activation of skin receptors and muscle structures. Each receptor is associated with a specific type of nerve fiber that transmits a specific type of sensitivity (sensation of pressure on the skin, vibration, stretching of the skin, and temperature sensitivity). An impulse is generated in the receptor, which is sent through nerve fibers at high speed to the nerve ganglia, which are a collection of sensory neurons. This is where primary information processing occurs to activate vital reflexes. Subsequently, the impulse goes to the brain, where it is processed in special nerve centers, and the person feels pain, pressure, vibration, etc. Thus, we can talk about the following types of sensitivity disorders:

Violation of surface sensitivity
occurs when receptors (temperature, tactile, pain, etc.) and nerve fibers of the facial skin are damaged.
Violation of deep sensitivity
occurs when the receptors and nerve fibers of the facial muscles are damaged.
Violation of complex types of sensitivity
. A similar type of disorder occurs when the cerebral cortex is damaged. There is no recognition of two different stimuli that simultaneously affect the skin, or the person cannot determine the location of the touch.

Possible causes of facial numbness
In many cases, numbness in different parts of the face is short-term, passing within a few minutes.

Such episodes can occur when the head is positioned in an awkward position, for example during sleep.

This occurs due to compression of the nerve fibers and a temporary disruption of impulse conduction. There is a burning and tingling sensation in the affected area. Partial loss of sensitivity is observed with prolonged exposure to the cold due to vasospasm. After gradual warming of the skin, sensitivity is restored.

However, facial numbness can be a symptom of a serious medical condition.

Acute cerebrovascular accident, or stroke

– a common cause of sudden numbness of the face in combination with a violation of facial activity. Hemorrhage or blockage of brain vessels by a thrombus (blood clot) occurs, acute oxygen deficiency and damage to neurons with disruption of their functions develops. Symptoms develop unexpectedly, sometimes accompanied by headache.

The main signs of a stroke are: numbness of the face and limbs on one or both sides, sudden weakness, speech impairment (inability to clearly pronounce words), drooping of the corner / corners of the mouth, uncoordination of movements.
If these symptoms appear, you should immediately seek medical help. A cerebral aneurysm
can cause numbness in the face due to compression of nerve fibers and sensitive centers of the brain. It usually develops gradually; at the onset of the disease, symptoms may be completely absent. Numbness first affects one area of the face (for example, perioral), and with further growth of the aneurysm, the affected area gradually expands. Sensations may also change: from tingling, burning at first - to a complete absence of sensations later.

There is a danger of rupture of a cerebral aneurysm; in this case, the symptoms are similar to those of a stroke and appear quickly.
Trigeminal neuritis
often accompanies inflammatory diseases of the oral cavity (caries, periodontitis), ear (otitis), paranasal sinuses (sinusitis, frontal sinusitis, ethmoiditis), parotid glands (mumps). The branches of the trigeminal nerve are irritated, which can lead to numbness in the corresponding areas of the face.

Impaired sensitivity with increased tone of the masticatory muscles

occurs due to compression of the branches of the trigeminal nerve by muscle fibers. Hypertonicity of the masticatory muscles is characteristic of damage to the temporomandibular joint due to arthritis and arthrosis, incorrectly selected braces, and certain diseases of the pharynx, for example, peritonsillar abscess.

Diabetes

– with this disease, the process of utilization of glucose from the blood is disrupted, which leads to damage to the vascular wall and disruption of the nutrition of nerve bundles. In the absence of maintenance therapy, tingling and partial loss of sensitivity in areas where the blood supply is impaired may occur.

Numbness of the face in multiple sclerosis

occurs due to demyelination (disappearance of the outer sheath) of the nerve fibers of the trigeminal nerve. Numbness is often preceded by severe pain not only in the face, but also in the limbs.

Tumors of the brain and its membranes

lead to impaired sensitivity in the facial area due to compression of the neurovascular bundles or tumor growth in them.

Which doctors should I contact if I have facial numbness?

If your face becomes numb, you should consult a neurologist or therapist. In some cases, consultation with an otolaryngologist, endocrinologist, or dentist may be required.

Diagnosis and examinations for facial numbness

Depending on the suspected cause of facial numbness, the following laboratory and instrumental studies may be required:

clinical blood test;

Disorders of facial innervation

A neurotic face may develop due to damage to the nerves that innervate it. Most often these are the trigeminal and facial nerves.

The trigeminal nerve is the 5th pair of cranial nerves. It is the largest of all 12 pairs of these nerve fibers.

N. trigeminus arises symmetrically on both sides of the face and consists of 3 large branches: the ophthalmic, maxillary and mandibular nerves. These three large processes innervate a fairly large area:

skin of the forehead and temples;
mucous membrane of the oral and nasal cavities, sinuses;
tongue, teeth, conjunctiva;
muscles - chewing, floor of the mouth, palatine, tympanic membrane.

Accordingly, when it is damaged, pathological sensations arise in these elements.

Facial nerve – 7th pair of cranial nerves. Its branches surround the temporal and ocular region, the zygomatic arch, and descend to and behind the lower jaw. They innervate all facial muscles: auricular, orbicularis and zygomatic, chewing, upper lip and corners of the mouth, cheek. As well as the muscles of the lower lip and chin, around the mouth, the muscles of the nose and laughter, and the neck.

N. facialis is also paired, and is located on both sides of the face.

In 94% of cases, the damage to these nerve fibers is unilateral, and only 6% is a bilateral process.

Disruption of innervation can also be primary or secondary.

Primary is the lesion that initially involves the nerve. This could be hypothermia or strangulation.

Secondary damage develops as a consequence of other diseases.

Another reason for the development of facial neurosis is neurogenic and mental disorders. When unpleasant sensations in the face and head occur against the background of psycho-emotional arousal, shock, or as a result of stressful situations.

Facial nerve neurosis

Neuritis (neurosis N. Facialis) or Bell's palsy occurs due to inflammation of the nerve fiber. Reasons leading to this condition:

pinched nerve as a result of narrowing of the channel through which it passes. This may be a congenital phenomenon or result from inflammation;
hypothermia;
other diseases and infections: herpes, mumps, otitis media, stroke, cancer, central nervous system infections;
injury N. Facialis.

The onset of the disease is usually gradual. Manifested by pain in the behind-the-ear area. After a couple of days, neurological facial symptoms appear:

smoothing of the nasolabial fold, drooping of the corner of the mouth;
the face becomes asymmetrical with a skew towards the healthy side;
eyelids do not droop. When you try to do this, your eye rolls;
any attempt to show at least some emotion ends in failure, since the patient cannot move his lips, smile, or manipulate his eyebrows. Such manifestations can worsen to the point of paresis and paralysis of the facial muscles, that is, to partial or complete immobility of the affected part of the face;
taste sensitivity decreases, salivation appears;
the eyes are dry, but there is lacrimation when eating;
hearing on the affected side worsens.

The severity of pathological symptoms depends on the degree and area of damage to the nerve fiber. If the disease is treated inadequately, complications may arise in the form of muscle contractures (immobility).

Since the disease is inflammatory in nature, its treatment is aimed at eliminating it. For this, the patient is prescribed hormonal anti-inflammatory drugs - glucocorticoids, as well as decongestants.

Other methods include:

prescription of vasodilators and analgesics, B vitamins;
anticholinesterase agents to increase nerve conduction;
drugs that improve metabolism in nervous tissue;
physiotherapy;
massage, exercise therapy in the recovery stage.

And only in extreme cases, when conservative therapy is ineffective, neurosurgical intervention is resorted to.

When your head hurts and your face goes numb

There may be several reasons for feeling unwell. And it is not always clear which doctor to contact with a particular ailment. Our expert will help you navigate. In order to get a complete answer, in the comments to this article you need to:

briefly outline the main symptoms;
make the question as specific as possible;
write a question in the comments under this article.

You will find answers to your questions in the next issue of the section “What kind of doctor do I need?”

Question: I have a terrible headache, and part of my head and face go numb. The hand goes numb, there is not enough air.

Headache is one of the most common symptoms and includes all types of pain and discomfort in the head area. There are four main types of headaches:

vascular headache occurs as a result of a mismatch between the resistance of the vascular wall and the increase in pulse volume of blood;
headache of muscle tension: with prolonged tension or compression of the soft tissues of the head;
liquorodynamic is associated with tension in the membranes of blood vessels (with an increase and decrease in intracranial pressure);
neuralgic pain occurs when pressure is applied to trigger zones.

There are also mixed headaches with a combination of the main types and psychalgia, or hypochondriacal headache, which occurs with mental disorders.

All types of headaches differ in location and connection with physical activity.

You should also differentiate between headaches and migraines. Migraine is an intense headache, usually unilateral, pulsating in nature, lasts up to 72 hours, may be accompanied by nausea, vomiting, hypersensitivity to light, sounds, etc., intensifies with physical activity. Some patients may experience an aura in the form of a short-term visual disturbance preceding an attack of headache. Facial numbness may also occur both during the aura and at the peak of the headache.

The patient needs to consult a neurologist to identify the cause of the headache, determine treatment tactics and prevent possible serious consequences of the disease.

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Question: At night I have a cough, as if something is tickling or bothering me in my throat.

Coughing is a protective reflex. It helps clear the airways of excess mucus or foreign bodies. The moment a person coughs, air abruptly leaves the lungs, forcing out what is obstructing breathing.

Tickling and discomfort in the throat can be the body’s reaction to internal and external irritants. Here are the main reasons for the development of cough and throat discomfort:

infectious diseases of the upper respiratory tract, both acute and chronic: pharyngitis, laryngitis, tonsillitis, rhinitis, etc.;
allergic reactions: this can be a seasonal exacerbation; allergens can also be pet hair, house dust, household chemicals, bed mites, low-quality bedding, feather or down pillows and blankets, house plants;
industrial aerosols (dust and gas contamination of atmospheric air);
smoking;
endocrine diseases: dryness of the oral mucosa in diabetes mellitus, formations of the thyroid gland, which can cause pressure on the larynx;
diseases of the gastrointestinal tract with reflux of gastric contents into the esophagus, worsening in a horizontal position of the body, which is accompanied by heartburn, belching, bitterness in the mouth and a sore throat;
autonomic disorders and neuroses after prolonged stress.

To determine the cause of a night cough and discomfort in the throat, you need to consult a general practitioner who, when collecting an anamnesis and examining the patient, will be able to determine the examination tactics and refer him to the necessary specialized specialists (otolaryngologist, allergist, endocrinologist, gastroenterologist, etc.).

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Question: Good afternoon. Fingers often go numb - the little and ring fingers on the right hand, sometimes they even turn blue, sometimes the whole palm turns blue. This also happens on the left hand, but less often. During sleep, the hands also turn blue, but completely, from the elbow to the tips of the fingers.

Blue discoloration of the upper or lower extremities is called peripheral cyanosis. Peripheral cyanosis (acrocyanosis) is associated with insufficient blood supply to small capillaries in areas of the skin distant from the heart. This disorder occurs due to narrowing of small capillaries and slow local blood circulation.

Peripheral cyanosis may be accompanied by cold hands and feet, and a feeling of numbness in the extremities. The causes of peripheral cyanosis may be:

neurohormonal changes associated with the menstrual cycle;
Raynaud's syndrome (secondary manifestation of a number of causes);
diseases of the cardiovascular system;
diseases of the bronchopulmonary system;
low blood pressure;
a number of systemic diseases;
hypothermia, etc.

The patient needs to see a general practitioner, who, after collecting an anamnesis and examination, will be able to determine the examination tactics and refer him to the necessary specialists. In this case, a visit to a cardiologist, neurologist, rheumatologist, pulmonologist, etc. may be required.

occupational therapist, head of the hospital “Clinics for the whole family 1 + 1”
answered your questions Photo depositphotos.com The author’s opinion may not coincide with the opinion of the editors

Trigeminal neuralgia

This is another lesion of the nerve fiber structure, which is often chronic and accompanied by periods of exacerbation and remission.
It has several causes, which are divided into idiopathic - when a nerve is pinched, and symptomatic.

The main symptom of neuralgia is paroxysmal sensations in the form of pain on the face and in the mouth.

Pain sensations have characteristic differences. They are “shooting” and resemble an electric shock; they arise in those parts that are innervated by the n.trigeminus. Having appeared once in one place, they do not change localization, but spread to other areas, each time following a clear, monotonous trajectory.

The nature of the pain is paroxysmal, lasting up to 2 minutes. At its height, a muscle tic is observed, that is, small twitching of the facial muscles. At this moment, the patient has a peculiar appearance: he seems to freeze, but does not cry, does not scream, and his face is not distorted from pain. He tries to make a minimum of movements, since any of them increases the pain. After the attack there is a period of calm.

Such a person performs the act of chewing only with the healthy side, at any time. Because of this, compaction or muscle atrophy develops in the affected area.

The symptoms of the disease are quite specific, and its diagnosis is not difficult.

Therapy for neuralgia begins with taking anticonvulsants, which form its basis. Their dose is subject to strict regulation and is prescribed according to a specific scheme. Representatives of this pharmacological group can reduce agitation and the degree of sensitivity to painful stimuli. And, therefore, reduce pain. Thanks to this, patients have the opportunity to freely eat and talk.

Physiotherapy is also used. If this treatment does not give the desired result, proceed to surgery.

Hemifacial spasm (facial hemispasm) - symptoms and treatment

The main goal of treatment for hemifacial spasm is to achieve stable remission without losing the patient’s ability to work and social activity [25].

medications are used to treat hemifacial spasm : clonazepam, levetirace, carbamazepine, baclofen, gabapentin [7]. They belong to anticonvulsants and muscle relaxants, affecting muscle tone and the ability to conduct nerve impulses. However, their effectiveness has not been reliably proven. In addition, patients are forced to take drugs for a long time in fairly high doses, which inevitably leads to side effects such as lethargy, drowsiness, lethargy, dizziness, muscle weakness, dyspeptic disorders, fluctuations in blood pressure, rhythm disturbances and cardiac conduction, and many others. which affects the quality of life.

For primary hemifacial spasm, neurosurgical intervention (microvascular decompression of the facial nerve) is possible, which has shown its effectiveness in 86-93% of cases of surgical treatment. It was developed and first performed in February 1966 by the American neurosurgeon Peter Jannetta [7]. First, the doctor makes an incision in the area behind the ear on the affected side, then cuts out a small area of bone. Having displaced the cerebellar hemisphere, the doctor determines the compression zone and eliminates it: delicately separates the vessel from the nerve and places a special biologically inert material - Teflon wool - between them. The bone defect is replaced with a bone fragment or a special plate, which is firmly fixed.

For secondary hemifacial spasms, it will be effective to eliminate the cause (removal of the tumor, exclusion of the aneurysm from the bloodstream, treatment of the underlying disease, etc.).

In the presence of contraindications to surgical treatment, in case of secondary hemifacial spasm, when surgical treatment is not indicated (stroke, multiple sclerosis, etc.), refusal of surgery, and in elderly people, injections of botulinum toxin type A (BTA) [1 ][7]. According to the recommendation of the European Federation of Neurological Societies (EFNS, 2011), BTA drugs are recommended as the first line of treatment for hemifacial spasm (recommendation class C) [28].

BTA is a highly effective treatment method for hemifacial spasm with minimal risk of adverse events and can be considered as an alternative to surgical treatment. It has been verified by controlled studies and 35 years of clinical practice [26]. Moreover, it is known that in 20% of cases of surgical treatment of hemifacial spasm, a relapse develops; side effects are frequent (impaired functions of the cranial nerves, infections, liquorrhea, hemorrhages), which are more difficult for patients to tolerate than BTA [7].

Californian ophthalmologist Alan Scott first used BTA in 1977 to treat strabismus. In 1985, he was the first to use local injections of BTA in humans for the treatment of blepharospasm and hemifacial spasm [29]. In 1985, neurologist Mitchell Breen published results of successful treatment of blepharospasm and hemifacial spasm using BTA [30]. Since then, BTA has been used not only in ophthalmology, but also in the treatment of diseases of the nervous system. The use of BTA was officially approved by the FDA (Food and Drug Administration - USA) in 1989. One of the first indications for the use of BTA was hemifacial spasm [31].

Botulinum toxin is produced by the gram-positive bacterium Clostridium botulinum. It is a neurotoxin that blocks the release of acetylcholine (a neurotransmitter that mediates the transmission of signals between neurons) from the presynaptic nerve ending. Thus, peripheral cholinergic (excited by acetylcholine) transmission at the neuromuscular synapse is disrupted. This reduces muscle contraction and leads to a dose-dependent, reversible decrease in muscle strength [25][26].

In Russia, the following BTA preparations are approved for use: conditionally 100-unit - "Botox", "Lantox", "Xeomin", "Relatox", "Botulax" (some drugs are available in bottles of 50 and 200 units) and " Dysport" (in bottles of 300 and 500 units). The drugs have similar effectiveness; they differ in storage and dilution features. Only in the instructions for the drug "Relatox" (Russia) hemifacial spasm is not included in the indications for use. The dosage of the drug is calculated individually for each patient and in accordance with the instructions for medical use. The conversion factor for units of action between Dysport and 100-unit drugs has been scientifically calculated; it is 3:1 or less for neurological indications and 2.5:1 for aesthetic indications [32]. The final dose calculation remains with the doctor. In Wolfgang Jost's atlas of botulinum therapy, doses are already indicated taking into account this recalculation per point of administration [33]. When treating hemifacial spasm, the average dose for Dysport can be 120-170 units. [14], for Xeomin - 30-50 units. depending on the muscles involved. The dose of administration at one point for Xeomin is 1.25-5 units. [33][34].

BTA is able to eliminate hyperkinesis during hemifacial spasm while preserving muscle function; it must be prescribed as soon as the diagnosis is made. Before carrying out botulinum therapy, the doctor must obtain voluntary informed consent for BTA injections. Injection sessions are recommended every 3-4 months in the target muscles. It is permissible to carry out injections “at the patient’s request,” that is, earlier or later than the recommended dates. This depends on the resumption of hemifacial spasm symptoms. After injections, it is recommended to actively contract the injected muscles for 20 minutes, and the patient should be under medical supervision for 1 hour to monitor for immediate allergic reactions [26]. To reduce the risk of developing intradermal hematomas on the face, it is recommended to cool the injection sites for 10-20 minutes.

A decrease in hyperkinesis after the administration of botulinum toxin is usually observed quite quickly - already on days 2-5, sometimes reaching the maximum effect by the end of the week (less often by days 10-14). The effect lasts up to 3-6 months. With regular repeated administrations of BTA, in most cases the positive effect is consolidated. The severity of hyperkinesis when they resume is less than before botulinum therapy and tends to decrease [14]. For facial symmetry in the muscles contralateral (on the opposite side) to the hemifacial spasm, it is necessary to perform BTA injections at 50% of the dose administered into the ipsilateral (on the side of the disease) muscles. It is advisable to do this after 2-3 weeks to evaluate the effect of the injected BTA and identify the muscles requiring aesthetic correction [35]. There is usually no decrease in sensitivity to BTA. Against the background of the effect of therapy, there is the possibility of gradual withdrawal of previously received medications [14][34].

More often, injections are performed in the following muscles: the circular muscle of the eye (orbicularis oculi); zygomaticus minor (zygomaticus major et minor); circular muscle of the mouth (orbicularis oris); subcutaneous muscle of the neck (platysma); frontal muscle (frontalis); muscle that wrinkles the eyebrow (corrugator supercilii); muscle that lowers the nose (procerus); nasal muscle (nasalis); muscle that lifts the upper lip and wing of the nose (levator labii superioris alaeque nasi); muscle that lifts the upper lip (levator labii superioris); laughter muscle (risorius); muscle that lifts the angle of the mouth (levator anguli oris). The drug should not be injected into the middle zone of the upper eyelid - in the projection of the muscle that lifts the upper eyelid, as this can lead to drooping of the eyelid [26][28].

Treatment with the drug should be carried out by specialists (neurologists, neurosurgeons) who have experience in the diagnosis and treatment of such conditions and have been trained in the treatment.

Contraindications to the use of BTA include pregnancy, hypersensitivity to one of the components of the drug, and acute diseases [26]. In the treatment of hemifacial spasm, according to various authors, temporary adverse reactions . They are distributed according to frequency as follows: very often - ptosis (drooping); often - weakness of the facial muscles, diplopia (double vision), dry eyes, swelling of the eyelids, lacrimation; infrequently - paresis (weakening) of facial muscles; rarely - ophthalmoplegia (paralysis of the eye muscles), entropion of the eyelid [26]. They do not require additional interventions and regress on their own within a few weeks [14][26][34]. To reduce the risk of side effects, it is important to maintain the dose of BTA and begin treatment with the minimum effective doses. Drugs that affect neuromuscular transmission, such as aminoglycoside antibiotics, should be used with caution during the period of BTA action [26].

To assess the effectiveness of treatment, scientists have developed a special system using five- and six-point scales. For example, according to Vincent Marneffe (neurosurgeon) [36], the result is considered “excellent” with the complete disappearance of hyperkinesis, “good” - if the disappearance is more than 80%, “satisfactory” - if the disappearance is from 20 to 80%, “unsatisfactory” - if hyperkinesis disappeared by less than 20%. Tetsuo Iwakuma et al [37], Peter Giannetta [21], Robert Auger et al [38] suggested “excellent,” “good,” “satisfactory,” “unsatisfactory,” “poor,” and “recurrent” results for the treatment of hemifacial spasm. One should strive to achieve “excellent” and “good” treatment results [7].

Drug therapy for hemifacial spasm is a thing of the past. Only in the presence of comorbid disorders (depression) can a doctor prescribe antidepressants in addition to the main treatment [25][26].

Thus, the use of BTA requires visiting a doctor 3-4 times a year without the need to constantly take other medications and undergo other procedures. It is also necessary to conduct cognitive behavioral therapy with patients for better social adaptation [25][26].

Real life examples

Some famous people, whose fame sometimes trumpets all over the world, were also hostage to the pathology of the facial nerve.

Sylvester Stallone, who is known for his enchanting roles, was injured at birth. The actor's mother had a difficult birth and he had to be pulled with forceps. The result is damage to the vocal cords and paresis of the left side of the face. Because of this, Stallone had problems with speech, which became a reason for ridicule from his peers.

The actor grew up as a difficult child. But, in spite of everything, he managed to overcome his defect and achieve considerable success, although partial immobility of his face remained.

Domestic showman Dmitry Nagiyev received facial asymmetry, which was nicknamed “Nagiyev’s squint”, due to paresis of the facial nerve. The illness happened unexpectedly. As a theater student, one day he felt that his face was not moving.

He spent 1.5 months in the hospital to no avail. But one day in his room a window broke due to a draft. Fright provoked a partial return of mobility and sensitivity of the facial part, but the left part retained its immobility.

Migraine

This condition is accompanied by attacks of unbearable headache. It is also associated with disruption of the trigeminal nerve, or more precisely, with its irritation in one part of the head. This is where the pain is subsequently localized.

The onset of migraine includes several stages:

initial;
aura;
painful;
final one.

Paresthesia of the head and face appears with the development of the aura stage. In this case, the patient is bothered by a feeling of tingling and crawling, which occurs in the arm and gradually moves to the neck and head. The person’s face becomes numb and it becomes difficult for him to speak. I am concerned about dizziness and visual disturbances in the form of light flashes, floaters and a decrease in the field of vision.

Facial paresthesia is a precursor to migraine, but often the attack occurs without the aura stage.

How to deal with facial numbness syndrome due to osteochondrosis

Osteochondrosis of the neck leads to irreversible changes in the vertebrae, which directly affect the general well-being of the patient and may manifest themselves in the form of symptoms that are similar to other pathologies. If discomfort occurs in the upper spine, or disruption of the normal movement of blood and lymph in the tissues of the head and face, it is necessary to conduct a comprehensive examination.

Why does the face go numb with osteochondrosis?

Unpleasant sensations, pain in the back and neck may indicate the development of osteochondrosis, which is formed due to the load on the vertebrae when the spine is in an uncomfortable, static-vertical position for a long time.

If there is damage to the vertebrae, cartilage and ligaments in the cervical region, then disturbances in the sensitivity of the skin of the face may occur, the normal mechanism of blood circulation may change, resulting in increased swelling. These symptoms appear due to changes that occur in bone cells during the development of the disease. Osteochondrosis is characterized by a decrease in the normal thickness of cartilage tissue, which leads to contact and friction of adjacent vertebrae. This can subsequently cause the development of inflammation, pinching of blood vessels, spinal cord nerves, and arteries.

These changes in the circulatory and nervous system of the body affect not only the normal functioning of the spine, but also respond with a burning sensation, numbness of the facial muscles, changes in tissue structure, and symmetry.

Diagnostic examination for osteochondrosis

The dangerous fact is that numbness and a burning sensation in the facial muscles can symbolize the spread of other diseases, for example, the brain, so if unpleasant symptoms occur, it is necessary to conduct a neurological examination.

Headaches and migraines, impaired facial symmetry, numbness, burning, tingling sensation, decreased muscle mobility can be manifestations of impaired blood flow in the brain, the development of tumor growths under the cranial bone, hemorrhage, and stroke. The difference is that in the presence of these symptoms of osteochondrosis, unpleasant manifestations on the face can go away when performing physical activity or, on the contrary, occur when staying in a certain body position for a long time. Also, with diseases of the spine, there is no disruption of mental functions or changes in mental activity, the patient maintains concentration, attention and clarity of thought.

Unfortunately, diagnosing and treating numbness of the facial muscles at home can lead to the progression of the disease. Therefore, it is especially important to conduct an X-ray and tomographic examination of the brain and spinal cord. This will reduce the likelihood of an incorrect diagnosis and help avoid many problems and complications by starting treatment on time.

Treatment of numbness of the facial muscles with osteochondrosis

The fight against the negative consequences of osteochondrosis of the cervical spine is carried out by a neurologist or vertebrologist, who are specialists in the field of diseases associated with the nervous system. As a rule, medications are prescribed after a comprehensive diagnosis, taking into account the individual characteristics of the course of the disease.

To combat disorders in muscle tissue and nerve endings on the face, it is first necessary to begin treatment for osteochondrosis:

With the help of medications that reduce inflammation in the vertebrae and nearby tissues;
Rubbing with ointments and creams that reduce pain;
Medicines that restore the cartilage layer and strengthen joints.

An effective remedy is also a back and neck massage, which improves blood circulation and lymph flow to the brain, saturating and nourishing muscle cells on the face.
Author: K.M.N., Academician of the Russian Academy of Medical Sciences M.A. Bobyr

Psychogenic causes of facial neurosis

Undoubtedly, disturbances in facial sensations quite often become a consequence of pathology of internal organs and blood vessels.

But often they are caused by psychological disorders and pathological thoughts that arise in our heads.

Facial paresthesias can be situational in nature and develop during episodic nervous excitement: as a result of quarrels, prolonged and intense screams. Such phenomena cause overstrain of the muscles, especially the cheeks and those located around the mouth. As a result, we experience facial numbness and even mild soreness.

The feeling of fear causes us to breathe quickly and shallowly, or to hold our breath. Disturbances in the respiratory rhythm can also provoke impressions that are atypical for us. A feeling arises that is characterized as a “chill running through.” Moreover, it is more concentrated at the roots of the hair. In this case they say: “chills to the marrow of the bones.” The face also becomes cold, a slight tingling appears in its area.

Such phenomena are disturbing when we are overwhelmed by strong emotions. But they accompany people suffering from mental disorders systematically.

A special type of neurotic facial manifestations is a nervous tic. It is characterized as an uncontrolled and systematic contraction of the facial muscles.

The disorder more often accompanies men. And it manifests itself with the following symptoms:

1.Motor:

frequent blinking, winking;
setting the lips with a tube;
nodding head;
constant spitting or sniffing;
opening or upturning of the corner of the mouth;
wrinkling of the nose.

2. Vocal:

screaming;
grunt;
coughing;
repetition of words.

There are also signs – precursors – that signal the appearance of a tic.
These include itching, facial heat and other paresthesias. Naturally, these signs are considered pathological if they occur in an inappropriate situation. It happens that only the patient himself feels them, but they are not visible to others.

But often twitching and other nervous symptoms become noticeable by other people, and they cause a lot of discomfort to the patient.

Tics can be simple, when there is only one symptom, or complex, which combines several manifestations.

The most common, main cause of tics is mental stress. It can be caused by a strong stress factor of one-stage action. Perhaps you were very scared of something, or broke up with your loved one. That is, the shock was so strong for you that your nervous system lost control.

Or, on the contrary, disorders develop as a result of prolonged monotonous exposure. Symptoms often appear due to lack of sleep and overwork.

Their duration varies. A situational nervous tic disappears a few hours or days after the cause is eliminated. In another case, it persists for years or haunts the patient throughout his life. In such a situation, in addition to eliminating the provoking factor, subsequent psychological work with the patient is required. This type of disorder is called chronic.

A nervous tic can be one of the signs of mental disorders such as neurosis, obsessive thoughts and phobias, depression.

Another group of provoking factors include:

diseases - stroke, brain injury, infections or poisons;
neurodegenerative diseases - Huntington's chorea. Characterized by destruction of brain tissue. Accompanied by uncoordinated, sudden movements, as well as neurological disorders of the face. Of these, the first sign is slow eye movements. Then a muscle spasm of the face occurs, which manifests itself in grotesque facial expressions - grimacing. Speech, chewing and swallowing are impaired;
burdened heredity;
parasitic infestations;
eye fatigue due to prolonged eye strain;
unbalanced diet, when the body receives little magnesium, calcium, glycine. These elements participate in the normal conduction of nerve impulses and are responsible for the coordinated functioning of the nervous system.

Nervous tics in children

There are several types of such disorders in childhood.

Transient tic disorder begins to manifest itself during early school age. Its duration ranges from 1 month to 1 year. Motor types of tics occur more often. Mainly typical for children with developmental delays and autism.

Chronic disorder occurs before age 18. And lasts from 1 year and above. In this case, either motor or vocal tics develop. The earlier the pathological symptoms appear, the easier and faster they pass.

Tourette syndrome is a multiple tic disorder characterized by both motor and movement types. A serious disease, which, however, softens with age.

A special type of disease, which is also characterized by signs of the nervous type, is minor chorea. It develops against the background of infections caused by streptococcus: sore throat, tonsillitis, rheumatism. Accompanied by pathological changes in nervous tissue.

Along with hyperkinesis, emotional instability, irritation, restlessness and anxiety, this condition corresponds to neurotic changes in the face. They are expressed in tension and spasms of the facial muscles, which is often mistaken for grimacing. There is also a spasm of the larynx, manifested in inappropriate screams.

At school, such children, not knowing the true cause of facial hyperkinesis, and even in combination with increased activity, are reprimanded and kicked out of class. Such an attitude towards the child forces him to miss school classes and avoid going to school. Treatment for chorea minor, along with sedatives, includes antibiotics to fight infection and anti-inflammatory drugs.

A nervous tic leaves a heavier imprint on a child’s psyche than on an adult. It often causes anxiety and detachment, withdrawal, and even provokes depressive disorders. Causes sleep disturbances, speech difficulties, and learning difficulties.

Tic disorders lead to distorted self-perception and decreased self-esteem.

Parents of such children are advised not to focus the child’s attention on the problem. On the contrary, they recommend finding ways to shift attention and increase self-esteem. A special place is given to support groups for such people and communication in general.

How to get rid of nervous tics

In order to free yourself from unpleasant sensations, you must first eliminate their problem. Sometimes all it takes is a good night's sleep. In another case, you need to change the situation for a while, get out of the destructive environment.

Among the auxiliary methods used are herbal soothing teas, baths with the addition of aromatic oils, swimming, walks in the fresh air or sports: running, yoga.

Add ingredients with a high content of calcium and magnesium to your menu. These include fermented milk products, buckwheat, bran bread, red fish, eggs, and meat. Vegetables and fruits include beets, currants, dried fruits, nuts and parsley.

If these foods do not fit into your diet, consider taking appropriate vitamin supplements. Do not overuse strong tea and coffee.

And most importantly: remain optimistic and calm in any situation!

In cases where the condition worsens, psychotherapy is sought. Cognitive behavioral therapy is especially effective in helping to stop tic disorders at the stage of their precursors.

Habit reversal therapy teaches patients movements that help prevent the development of neurological facial symptoms.

Medications include anticonvulsants and muscle relaxants, Botox injections, and antidepressants.

If the above methods are ineffective in combating nervous tics, they turn to deep brain stimulation. A device is installed in the GM that controls electrical impulses.

How to remove teak yourself

If a nervous facial tic is situational and is not too intense, but at the same time obsessive, you can try to get rid of it using physical methods.

One way is to try to disrupt the pathological muscle rhythm by overexerting it. For example, if your eye twitches, try to close your eyes tightly.

It is possible to calm an overexcited muscle through a light massage. Or apply cold to it. The temperature difference will also help. Wash your face alternately with cold and warm water.

Dermatillomania

Neurosis of the face and scalp can manifest itself in a behavioral disorder such as dermatillomania.

Its main manifestation is scratching the skin of the face and head, not because of itching, but because of dissatisfaction with its appearance. This also includes an obsessive zeal to squeeze out pimples, scratch off scabs, and pull out hair. Self-injurious actions cause a short-term feeling of pleasure, followed by feelings of shame, frustration, and dissatisfaction.

The face of such patients is covered with scars and scars due to constant trauma to the skin. This process is uncontrollable and can occur at any time of the day. But most often traumatic actions are carried out in front of a mirror.

Symptoms of the disorder also include the habit of biting the lips and mucous membranes of the cheeks. Patients are not deterred by the prospect of redness, bleeding, and scarring of the skin. They repeat the ritual day after day. It lasts from a few minutes to an hour.

Such actions can be provoked by feelings of fear, anxiety, and close examination of one’s skin because there is nothing to do.

Dermatillomania has been described as a state of addiction. It begins with concentrating on what the patient thinks is a skin defect. Gradually, attention is increasingly focused on this detail. A person begins to think that he is sick with something serious. This provokes irritability and nervousness in him, leading to obsessive actions.

The root cause of the disease is rooted in the psychological state of a person and lies in self-dissatisfaction, anger, feelings of shame and malice. Traumatic rituals are a way of punishment, self-flagellation.

Treatment of this pathology requires the intervention of a psychotherapist and a dermatologist.

The main method of treating addiction is psychotherapy, in particular cognitive behavioral therapy.

Yoga, physical exercise, relaxation procedures, as well as any hobby that absorbs a person and helps redirect attention will help reduce anxiety, distract and relax.

The help of a dermatologist is necessary to eliminate skin lesions in order to prevent infection and reduce the degree of dermatological defect.

Causes of pain in the back of the head in an adult

“Pain in the back of the head itself does not indicate the cause of this pain,” explains neurologist Elena Gaivoronskaya.
– The doctor assesses the frequency of pain, its intensity, duration, nature (pulsating, pressing, stabbing), associated symptoms. Only on the basis of all this data can a diagnosis be made. There are a number of reasons why headaches may occur predominantly in the back of the head.

headaches .

This is the most common cause of pain in the back of the head. Such pain can last from 30 minutes to 7 days. Such pain can be caused by severe stress, overwork, lack of sleep, malnutrition, poor posture or not drinking enough water.

Patients with this problem usually feel tension in the back or front of the head. The pain can range from dull to severe.

Migraine.

Another common type of headache that often appears in childhood and gets worse with age. Migraines are most common in women. Its symptoms include severe pain on one side of the head with nausea, vomiting and blurred vision. Patients are usually sensitive to light, noise, or smell. Physical activity may increase pain. It can last from several hours to several days.

Causes of migraines include emotional or physical stress, environmental and dietary changes. Sometimes medications (such as birth control pills) can also cause migraines.

Overuse of medications or recurring headaches.

These headaches can develop if a person takes too many painkillers. They are very strong and are often accompanied by nausea, anxiety, irritability, fatigue, difficulty concentrating, memory loss and even depression.

Occipital neuralgia.

A rare but severe headache that usually begins at the base of the neck and spreads to the back of the head and then behind the ears. Often occurs when the occipital nerves, which run up the back of the neck to the base of the skull, are damaged or irritated. The pain is accompanied by a burning or shooting sensation and persists on one side of the head, but often intensifies with movement of the neck. The patient is usually sensitive to light.

Possible causes include spinal injury, tumors, nerve damage caused by diabetes, swollen blood vessels, and rarely infection.

Headaches during physical activity.

They occur as a result of stressful activities and often occur after physical exercise. This pain resembles palpitations and can last from 5 minutes to 2 days.

Often occurs after heavy weight exercise or running. But sometimes they happen after sexual intercourse or pushing in the toilet.

Headache due to arthritis.

It appears in the back of the head and intensifies with movement. May be the result of arthritis of the first, second or third vertebra. Either it is associated with changes in the bone structure of the neck or inflammation of the blood vessels in the head.

In addition, the cause of a headache in the back of the head can be:

osteochondrosis of the cervical spine;
high blood pressure;
increased intracranial pressure;
stress;
brain tumors;
brain aneurysm;
subarachnoid cerebral hemorrhage;
cervical spine injuries and traumatic brain injuries;
meningitis.

Neuroses

This is a large group of diseases, manifested primarily in psycho-emotional disorders, as well as malfunctions of the autonomic nervous system. They do not cause pathological disorders of the nervous tissue, but have a significant impact on the human psyche.

There are several types of disorders in which the symptoms are visible.

Muscular neurosis is manifested by muscle tension, spasm and convulsive twitching. Neurosis of the facial muscles makes itself felt with the following manifestations:

nervous tic;
lip tension, clenching;
convulsive contraction, the face seemed to move;
tingling, burning sensation;
muscle pain;
Tension of the neck muscles is manifested by a feeling of lack of air, a lump in the throat.

When we find ourselves in a stressful situation, our body produces stress hormones. They, among many other reactions, cause muscle tension. Now imagine, if we are exposed to chronic stress, what happens to our muscles, and specifically to the muscles of the face. Being systematically in hypertonicity, they overexert themselves. This is what causes their nervous twitching, spasms, and convulsions.

Another type of neurosis is skin. It causes paresthesias in the facial skin of the following type:

severe itching, burning in the facial and scalp without clear localization;
sensation as if something were touching the face. And it's terribly annoying;
the appearance of red spots on the face and neck. Possible rash.

The causes of such phenomena are nervous and mental overstrain, chronic stress, sleep disturbances, as well as disruptions in hormonal regulation.

With neuroses associated with disruption of the autonomic nervous system, various manifestations may also occur. Malfunctions in the functioning of the vascular network occur, and a vascular neurotic disorder develops.

Vascular neurosis of the face is manifested by flaking and dryness, a feeling of tightness of the skin. She becomes pale, sometimes cyanotic, and her sensitivity worsens. In addition, sneezing appears, the nose is stuffy, the eyes become red and watery, the skin itches and itches. This indicates the development of vegetative-allergic reactions.