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Facial Numbness Symptoms, Causes & Common Questions

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Understand your facial numbness symptoms, including 6 causes & common questions.

9 most common causes

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Shingles
Myofascial Pain Syndrome
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Transient Ischemic Attack
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Low Calcium Level (Hypocalcemia)
Bell's Palsy
Panic Disorder
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Nose or sinus tumor
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Multiple sclerosis (MS)
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Hyperparathyroidism

Facial numbness quiz

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Symptoms of facial numbness

Facial numbness is the inability to feel normal sensations on all or part of the face. This phenomenon may be quite noticeable to you and somewhat alarming. However, it is possible for facial numbness to be first discovered by a medical provider using objects such as a cotton ball to test sensation. Facial numbness can occur in isolation, but there may be other areas of the body with abnormal sensation or additional symptoms. The numbness can develop gradually or suddenly, depending on the cause.

Facial sensation depends on signals sent by a large cranial nerve located in the face called the trigeminal nerve. These signals travel through the brainstem and are interpreted in the brain. A problem in the trigeminal nerve, the pathway from the nerve to the brain through the brainstem, or the brain itself can contribute to facial numbness.

Characteristics of facial numbness

Symptoms that can be associated with facial numbness depending on the underlying cause include:

Causes of facial numbness

Causes of facial numbness are described below from most to least common, including neurological abnormalities, injuries, other medical conditions, or a psychiatric cause.

Neurological abnormalities

Causes of facial numbness related to neurological abnormalities may include:

  • Stroke: A stroke (decreased blood flow caused by a clot or bleeding) in the brain or brainstem can cause sudden-onsetone-sided facial numbness. Other symptoms will also be present, such as weakness, clumsiness, and numbness in the arm and leg. The affected limbs will be on the same or opposite side of the facial numbness depending on the location of the stroke.
  • Tumors: A benign or malignant tumor affecting the sensory pathway for facial sensation can cause numbness. This can occur with a tumor in the head and neck area, brain, or one of the cranial nerves near the trigeminal nerve. Depending on the location of the tumor, other possible symptoms include a spinning sensation, hearing loss, and enlarged lymph nodes in the neck.
  • Other neurological disorders: Trigeminal neuralgia, a condition caused by damage to the trigeminal nerve, can cause facial numbness. Numbness will be followed by an episode of severe facial pain. Disorders such as multiple sclerosis (MS) can also lead to facial numbness, often with other neurological symptoms present.

Injuries

Injuries that can lead to facial numbness may include the following.

  • Facial trauma: A fracture or swelling after a facial injury can cause numbness.
  • Surgery: Rarely, an injury to the trigeminal nerve during facial surgery (such as a facelift) can produce facial numbness.

Other medical conditions

Other medical conditions that can lead to facial numbness may include:

  • Low calcium: An abnormally low level of calcium (hypocalcemia) in the body can cause neurological symptoms including numbness or tingling around the mouth.
  • Scleroderma: Facial numbness is one of the most common neurological complications of the connective tissue disease scleroderma. Tingling and pain are usually also present.

Psychiatric cause

A feeling of numbness in the body, including in the face, can be perceived in the absence of a physical cause. A physical exam from a medical provider can usually determine whether facial numbness is psychological in nature.

This list does not constitute medical advice and may not accurately represent what you have.

Facial numbness quiz

Take a quiz to find out what's causing your numbness.

Take facial numbness quiz

Stroke or tia (transient ischemic attack)

Transient ischemic attack, or TIA, is sometimes called a "mini stroke" or a "warning stroke." Any stroke means that blood flow somewhere in the brain has been blocked by a clot.

Risk factors include smoking, obesity, and cardiovascular disease, though anyone can experience a TIA.

Symptoms are "transient," meaning they come and go within minutes because the clot dissolves or moves on its own. Stroke symptoms include weakness, numbness, and paralysis on one side of the face and/or body; slurred speech; abnormal vision; and sudden, severe headache.

A TIA does not cause permanent damage because it is over quickly. However, the patient must get treatment because a TIA is a warning that a more damaging stroke is likely to occur. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through patient history; physical examination; CT scan or MRI; and electrocardiogram.

Treatment includes anticoagulant medication to prevent further clots. Surgery to clear some of the arteries may also be recommended.

Rarity: Common

Top Symptoms: dizziness, leg numbness, arm numbness, new headache, stiff neck

Symptoms that never occur with stroke or tia (transient ischemic attack): bilateral weakness

Urgency: Emergency medical service

Shingles (herpes zoster)

Shingles (herpes zoster) is a disease caused by the varicella-zoster virus - the same virus that causes chickenpox. Early signs of shingles include burning or shooting pain and tingling or itching, usually on one side of the body or face. Rashes or blisters appear anywhere from one to 14 days later. If shingles appears on the face, it may affect vision or hearing.

You should go to a retail clinic or your primary care physician to be treated for shingles. Most common treatments involve pain killers and prescription antiviral medicines.

Panic or anxiety attack(s)

Panic disorder means a generalized set of symptoms involving sudden, unexplained feelings of anxiety and overwhelming fear. The physical symptoms are very real and consist of sweating, pounding heart, and shortness of breath.

The cause is not known. It may involve changes in brain chemistry that cause a person to perceive danger where there actually is none. Severe and ongoing stress, as well as post-traumatic stress disorder (PTSD) may be factors.

Panic disorder is most common among women. It can affect anyone, however, especially with a family history.

This condition does not improve on its own. If left untreated, the patient may become isolated and even suicidal.

A doctor will do a complete workup, including blood tests, to rule out any physical causes for the symptoms. A psychological workup will also be done.

The first line of treatment is talking with a professional who can help with coping and stress management. Medication, including some antidepressants and calming drugs, may be used temporarily but can cause dependence and unpleasant side effects if used for too long.

Rarity: Common

Top Symptoms:

Symptoms that always occur with panic or anxiety attack(s): anxiety or anxiety/panic attacks

Urgency: Primary care doctor

Nose or sinus tumor

A tumor in the nose or one of the sinuses occurs due to abnormal growth of the cells lining the inside of the nose and sinuses. These tumors are rare and can cause symptoms like congestion or blockage, nose bleeds and sometimes facial pain or swelling.

You should visit your primary care physician to discuss your symptoms and to get further tests done. Referral to an ENT surgeon is likely needed.

Rarity: Ultra rare

Top Symptoms: new headache, congestion, vision changes, ear fullness/pressure, ear pain

Symptoms that never occur with nose or sinus tumor: improving congestion

Urgency: Primary care doctor

Myofascial pain syndrome

Myofascial pain syndrome is also called chronic myofascial pain (CMP.) Pressure on certain points of the muscles causes referred pain, meaning the pain is felt elsewhere in the body.

The cause is believed to be muscle injury through overuse, either from sports or from a job requiring repetitive motion. Tension, stress, and poor posture can also cause habitual tightening of the muscles, a form of overuse.

This overuse causes scar tissue, or adhesions, to form in the muscles. These points are known as trigger points, since they trigger pain at any stimulus.

Symptoms include deep, aching muscular pain that does not go away with rest or massage, but may actually worsen. There is often difficulty sleeping due to pain.

Myofascial pain syndrome should be seen by a medical provider, since it can develop into a similar but more severe condition called fibromyalgia.

Diagnosis is made through physical examination and applying mild pressure to locate the trigger points.

Treatment involves physical therapy, pain medications, and trigger point injections. In some cases, acupuncture and antidepressants are helpful.

Multiple sclerosis (MS)

Multiple sclerosis, or MS, is a disease of the central nervous system. The body's immune system attacks nerve fibers and their myelin covering. This causes irreversible scarring called "sclerosis," which interferes with the transmission of signals between the brain and the body.

The cause is unknown. It may be connected to a genetic predisposition. The disease usually appears between ages 20 to 50 and is far more common in women than in men. Other risk factors include family history; viral infections such as Epstein-Barr; having other autoimmune diseases; and smoking.

Symptoms include numbness or weakness in arms, legs, or body; partial or total loss of vision in one or both eyes; tingling or shock-like sensation, especially in the neck; tremor; and loss of coordination.

Diagnosis is made through patient history, neurological examination, blood tests, MRI, and sometimes a spinal tap.

There is no cure for MS, but treatment with corticosteroids and plasma exchange (plasmapheresis) can slow the course of the disease and manage symptoms for better quality of life.

Rarity: Rare

Top Symptoms: severe fatigue, constipation, numbness, decreased sex drive, signs of optic neuritis

Urgency: Primary care doctor

Low calcium level

Hypocalcemia is a condition where there is not enough calcium in the blood. Calcium is a mineral contained in the blood and helps the heart and other muscles function properly. It is also needed to maintain healthy teeth and bones. Low calcium levels can cause bones to become brittle and more easily fractured. Parathyroid issues and vitamin D deficiency are common causes of this condition.

You should consider visiting a medical professional to discuss your symptoms. Low calcium levels can be evaluated with a review of your symptoms and a blood test. Once diagnosed, treatment depends on the cause of your low calcium levels.

Hyperparathyroidism

The four parathyroids are tiny glands that lie behind the thyroid gland in the neck and control calcium levels in the blood and bones.

In most cases, enlargement of one or more of the parathyroids causes overproduction of parathyroid hormone (PTH.) This is followed by hypercalcemia, or high blood calcium levels.

Sometimes a benign or malignant tumor on one of the parathyroids is the cause. Other causes are chronic kidney failure or a deficiency of calcium and/or vitamin D.

Most at risk are women past menopause with a pre-existing calcium deficiency; radiation treatment to the neck; or use of the drug lithium.

Early symptoms are those of hypercalcemia: brittle bones, excessive urination, tiring easily, depression, and generally feeling ill with no clear cause.

If not treated, hyparathyroidism can lead to osteoporosis, kidney stones, and cardiovascular disease.

Diagnosis is made through blood test. Bone mineral tests, urine tests, and imaging of the kidneys may be ordered.

Treatment includes monitoring; medications called calcimimetics or bisphosphonates; and surgery to remove the affected parathyroid glands.

Bell's palsy

Bell's palsy can present as acute or chronic facial paralysis. This paralysis is usually sudden in onset and worsens over the course of 48 hours. Resolution of symptoms usually occurs within two weeks to six months but permanent paralysis can rarely occur. Symptoms of this condition are a result of the paralysis of facial muscles. This paralysis usually occurs only on one side of the face. The cause of Bell’s palsy is inflammation or damage to the facial nerve, also known as cranial nerve VII. This nerve controls the muscles of the face. Treatment is aimed at reducing inflammation or targeting the underlying cause of facial nerve paralysis.

Rarity: Uncommon

Top Symptoms: arm weakness, facial numbness, arm weakness, hearing loss, pain on one side of the face

Symptoms that always occur with bell's palsy: face weakness, weakness in one side of the face

Urgency: Primary care doctor

Facial numbness quiz

Take a quiz to find out what's causing your numbness.

Take facial numbness quiz

Facial numbness treatments and relief

Going to a medical provider for diagnosis and treatment of a medical condition is the best way to approach facial numbness. Home treatments are unlikely to be effective.

When facial numbness is an emergency

Some causes of facial numbness can be dangerous and require immediate evaluation and treatment, such as:

  • Sudden, widespread numbness and/or weakness: Sudden-onset facial numbness along with other neurological symptoms such as numbness and/or weakness in other parts of the body require urgent care.
  • Seizures or difficulty breathing: These symptoms are consistent with a severely low calcium level, which requires treatment to prevent cardiac arrhythmias and other complications.
  • Facial injury: This requires urgent care when occurring with numbness, disfigurement, difficulty breathing, or any other significant symptoms.

When to see a doctor for facial numbness

In some cases, even if emergency care isn't necessary, you may need evaluation and treatment. Make an appointment with your medical provider if:

  • Your facial numbness does not resolve or gets worse
  • You are experiencing episodes of facial pain along with numbness
  • You have gradually developed other neurological symptoms: Such as a spinning sensation, hearing loss, visual changes, or weakness
  • You have enlarged lymph nodes in the neck

Medical treatments

Your medical provider may prescribe one or more of the following treatments, depending on the cause of your facial numbness:

  • Medication: This can treat an underlying disorder such as trigeminal neuralgia or multiple sclerosis.
  • Therapy: A therapy program can identify and address underlying psychological difficulties that may be contributing to facial numbness.
  • Surgery: Referral for surgical management of a tumor or trigeminal neuralgia that has not responded to other treatments.

FAQs about facial numbness

Can facial numbness be a sign of a stroke?

Numbness on one side of the face can be caused by a stroke. Facial numbness will not be the only symptom if a stroke is the cause. Other possible symptoms include numbness and/or weakness in the arm and leg, which can be on the same side or opposite side from the facial numbness depending on the location of the stroke. You should seek emergency treatment if you notice sudden onset of facial numbness, especially if you have any other neurological symptoms.

Why is my face numb only on one side?

Many causes of numbness will affect only one side of the face. A stroke occurs on one side of the brain or brainstem, so only one side of the face is affected by sensory abnormalities. Each side of the face has a trigeminal nerve, which communicates facial sensation to the brain; an abnormality of one of the trigeminal nerves will affect sensation only on the corresponding side. A tumor will cause facial numbness on only one side, while an injury could cause numbness on one or both sides depending on the location.

Will facial numbness eventually go away?

Many causes of facial numbness will resolve on their own or with treatment. Numbness after an injury will likely go away as healing occurs. If multiple sclerosis is the cause, sensation will typically return to normal, but treatment will be required to help prevent future neurological abnormalities. Numbness following a stroke may resolve over time, but the prognosis is unpredictable.

What causes facial numbness after an injury?

Numbness of part of the face can occur after a severe trauma, such as a sports injury or car accident. If the numbness starts directly after the injury, it may be caused by nerve damage that occurred via a fracture of one of the facial bones. Facial numbness that develops gradually after an injury is more likely caused by post-traumatic swelling.

Can facial numbness be a sign of cancer?

Rarely, cancer can be the cause of facial numbness. The trigeminal nerve, which communicates sensory signals from the face to the brain, can be damaged by a tumor of the head and neck or a neighboring nerve. A brain tumor can also cause loss of facial sensation. Facial numbness is unlikely to be the only sign of a tumor: other possible symptoms include hearing loss, a spinning sensation, and enlarged lymph nodes in the neck.

Questions your doctor may ask about facial numbness

  • Have you lost some or all of your sense of taste?
  • Have you been experiencing any muscle weakness that is symmetrical (equal on both sides of your body)?
  • Have you ever been diagnosed with a psychiatric issue, such as depression, bipolar, schizophrenia, or anxiety disorder?
  • Are you having any difficulty speaking?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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References

  1. Smith JH, Cutrer FM. Numbness Matters: A Clinical Review of Trigeminal Neuropathy. Cephalalgia. 2011;31(1):1131-1144. NCBI Link
  2. Trigeminal Neuralgia Fact Sheet. National Institute of Neurological Disorders and Stroke. Updated July 6, 2018. NINDS Link
  3. Blahd WH, Husney A, Romito K. Facial Problems, Noninjury. University of Michigan: Michigan Medicine. Updated November 20, 2017. UofM Health Link
  4. Cohen J, Fadul C, Jenkyn L, Ward T. Disorders of the Nervous System. Dartmouth College. Published 2008. Dartmouth LInk
  5. Trigeminal Neuralgia. American Association of Neurological Surgeons. AANS Link