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What Can Cause Tingling in the Face (Facial Paresthesia)?

Paresthesia is defined by a sensation of tingling, numbness, burning, or loss of sensation (more or less pronounced) in a part of the body. This change in sensitivity is often unpleasant, and can sometimes cause pain. When paresthesia is facial, it usually affects one side of the face and may occur especially following a tooth extraction with anesthesia, trauma (e.g. a broken nose), allergies, or some neurological diseases (e.g. multiple sclerosis).

Damage to the nerve that ensures the sensitivity of the face — called the trigeminal nerve — is called trigeminal neuralgia, which may be primary, without an identified cause, or secondary to another disease. Another type of paresthesia is called cluster headaches.

Symptoms of Facial Paresthesia

In trigeminal neuralgia, symptoms include pain in the face, spontaneous or triggered by chewing; pain that affects only one side of the face; and brutal onset, like that of an electric shock.

In the case of cluster headaches, symptoms include intense, almost tearing or burning pain on one side of the face; appearance several times a day for several months.

Diagnosis of Facial Paresthesia

In cases of facial paresthesia, usually relatively well described by the patient, it is essential to find the origin. Besides trauma, allergies, or dental procedures, facial paresthesia may have a severe neurological cause. To identify the cause, brain imaging is frequently performed, often in the form of an MRI.

Treatment of Facial Paresthesia

To treat facial paresthesia, it is essential to know the cause. Once it is identified, treatment can decrease or cure the paresthesia.

In the case of trigeminal neuralgia, anti-epileptic drugs are often effective, and surgical treatment is also possible.

Apart from these treatable causes, symptomatic treatment can be undertaken. For multiple sclerosis, cortisone is administered. For cluster headaches a molecule, sumatriptan, often is efficient. During the evolution of these attacks, background therapy is also often used.

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