[18F] With facial tingling and muscle twitches

Patient Description

An 18-year-old female has been experiencing a tingling sensation in her face since June, described as feeling like tiny bugs crawling under the skin. Initially affecting the right side, it has spread to the left side. The sensation is mostly constant, exacerbated by stress and darkness, and occasionally absent. Muscle twitches occur randomly across the body, including the head and face, along with muscle spasms in the face and head. There are also pains behind the ears and shooting pains from the neck to the back of the head. Soft tingling is felt in the hands, legs, arms, and face. The patient reports occasional blurring of peripheral vision in the right eye, a few stress-related headaches, and a week-long episode of vertigo without nausea or vomiting. No weakness or difficulty with facial movements, speech changes, or limb numbness is noted, except for facial numbness. A family history of migraines is present, but the patient has no chronic conditions or medications. Recent blood tests were normal. A lower spine injury occurred four years ago.

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Arora's Assessment

What might be happening

Based on your symptoms, here are some possible explanations:

  • Trigeminal Neuralgia: This condition involves facial nerve pain and can cause tingling or a crawling sensation. Stress and certain triggers can worsen symptoms. Treatment often includes medications to manage nerve pain.

  • Migraine with Aura: Given your family history, migraines could explain the tingling and visual changes. Migraines can cause sensory disturbances and are often triggered by stress or bright lights. Treatment includes lifestyle changes and medications to prevent or relieve symptoms.

  • Cervical Spine Issues: Your past spine injury might contribute to nerve-related symptoms, including tingling and muscle spasms. Imaging tests like an MRI can help assess this.

  • Peripheral Neuropathy: This involves nerve damage that can cause tingling and muscle spasms. It’s less common in your age group without underlying conditions but worth considering.

What you can do

  • Consult a Healthcare Provider: It's important to see a doctor for a thorough evaluation and possible tests, such as imaging or nerve studies.

  • Manage Stress: Practice stress-reduction techniques like deep breathing, meditation, or yoga, which may help reduce symptoms.

  • Track Symptoms: Use MDandMe to journal your symptoms, triggers, and any changes. This information can be valuable for your healthcare provider.

  • Healthy Lifestyle: Ensure you’re getting enough sleep, staying hydrated, and maintaining a balanced diet.

What you should look out for

  • Seek Immediate Care: If you experience sudden weakness, severe headache, vision changes, or difficulty speaking, seek medical attention promptly.

  • Monitor Symptoms: If symptoms worsen or new symptoms develop, contact your healthcare provider.

Remember, this information is not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and treatment plan.

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6 mo ago

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People Also Ask


What could cause a tingling sensation in the face?

A tingling sensation in the face can be caused by conditions such as trigeminal neuralgia, migraines, cervical spine issues, or peripheral neuropathy. It is important to consult a healthcare provider for an accurate diagnosis.


How can stress affect symptoms like tingling and muscle spasms?

Stress can exacerbate symptoms like tingling and muscle spasms by increasing muscle tension and affecting nerve function. Stress management techniques such as meditation, deep breathing, and yoga can help alleviate these symptoms.


What are the potential links between migraines and visual disturbances?

Migraines, especially those with aura, can cause visual disturbances such as blurring or seeing flashes of light. These symptoms are often triggered by stress, bright lights, or certain foods. Managing migraines typically involves lifestyle changes and medications.


When should I seek immediate medical attention for these symptoms?

Immediate medical attention should be sought if you experience sudden weakness, severe headache, significant vision changes, or difficulty speaking, as these could indicate a more serious condition requiring urgent care.


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