Numbness: extremities - arms and legs, head, face and other parts of the body

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

35473 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:

1. Violation of surface sensitivity
   occurs when receptors (temperature, tactile, pain, etc.) and nerve fibers of the facial skin are damaged.
2. Violation of deep sensitivity
   occurs when the receptors and nerve fibers of the facial muscles are damaged.
3. 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.

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].

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.

My legs are going numb

The presence of a certain pathology may also cause numbness in the toes.

Numbness of the lower extremities accompanied by intense pain after physical activity is characteristic of vascular pathology, which leads to impaired circulation and damage to nerve tissue:

• Obliterating endarteritis (thromboangiitis obliterans, Buerger's disease);
• Trophic ulcer;
• Varicose veins;
• Thrombophlebitis;
• Thrombosis of blood vessels of the legs;
• Chronic venous insufficiency;
• Atherosclerosis of blood vessels of the lower extremities;
• Polyneuropathy;
• Diabetic foot syndrome, which, however, refers to the clinical manifestations of polyneuropathy, which is a complication of diabetes mellitus.

in case of numbness of the legs, a significant role, along with osteochondrosis, is played by vascular problems of the legs - affecting the arteries (in particular atherosclerosis - a) and veins (venous stasis coupled with varicose veins and CVI - b)

The toes also go numb with neuralgia of the sciatic nerve, which we call sciatica.

The disease, as a rule, is accompanied by “lumbago” in the lumbar region and in the leg; it is often a consequence of pathological changes in the lumbosacral spine:

• Intervertebral hernia;
• Osteochondrosis of the lumbar region;
• Bruises, fractures and other traumatic injuries.

Pregnant women who have very little time left before giving birth often complain of numbness in their legs. Their lateral thighs are more likely to suffer. The cause of discomfort, in addition to the additional burden on the body, may be a deficiency of iron and other microelements. In this case, cramps and other symptoms may be added to the numbness.

Thus, various pathological conditions affecting nerves and blood vessels can cause numbness in the toes.

And to complete the picture, let’s add some more diseases to the existing list:

• Diabetes;
• Exposure to low temperatures leading to frostbite;
• Raynaud's disease and syndrome;
• Tumors of peripheral nerves;
• Angiopathy of various origins;
• TIA (transient ischemic attack);
• Multiple sclerosis;
• Lower limb tunnel syndrome (tunnel neuropathy, nerve compression in the canal);
• Stroke and its younger “brother” (micro-stroke);
• Rheumatoid arthritis.

Of course, short-term pressure on a nerve (poor posture) and numbness in the toes is not a reason to immediately run to the doctor. You should think about it when tingling occurs frequently and is accompanied by other symptoms.

(pain, loss of sensitivity, loss of coordination of movements). And if a person cannot understand whether he has immersed his foot in water - cold or hot, a visit to the doctor should be urgent.

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.

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.

Numbness of the head, face, lips, tongue

Part of the head may become “foreign” as a result of suffering from the nerves and blood vessels passing there.

Numbness is often accompanied by pain and cramps in individual muscle fibers. Unpleasant sensations can be limited to a specific place on the face, localized in some part of the head (left or right half) or cover the entire head, spreading to the back of the head. Other patients complain only of problems affecting the oral cavity (numbness of the tongue), but do not notice them in other parts of the head. Thus, numb areas can find a place in various parts of the facial skull, oral cavity, move to the back of the head or move to the neck and shoulder girdle:

1. Severe headache, convulsive twitching, numbness of the face - symptoms characteristic of trigeminal neuralgia
   ;
2. As a cause of pain, numbness of the tip of the tongue, dryness of the oral mucosa without changing its color, glossalgia
   , which is often present in people with a main diagnosis of
   vegetative-vascular dystonia (
   NCD, autonomic dysfunction, etc.);
3. Autonomic dysfunction
   can cause pain and numbness in other parts of the head (face, temporal region, back of the head), as well as numbness of the fingers, trembling, increased body temperature, the appearance of panic attacks and other autonomic disorders;
4. A sudden numb spot on the face, an aura that followed the numbness with nausea and multi-colored circles, zigzags, flashes, glare in front of the eyes and the addition of a severe headache a little later - a picture that most likely represents a combination of symptoms of migraine
   ;
5. Along with dizziness, tinnitus, heaviness in the head and other symptoms, the feeling that the back of the head has become “wooden” is often present in people with osteochondrosis of the cervical spine
   and impaired blood flow in the vertebral arteries (vertebrobasilar insufficiency).
6. Problems in the oral cavity (smooth “varnished” tongue, numbness) can be caused by B12 deficiency anemia
   . It should be noted that the triad characteristic of this disease (damage to the blood, gastrointestinal tract and nervous system) entails the appearance of many other symptoms, including sensitivity disorders in different parts of the patient’s body;
7. A rash, redness of a “dead” area on the face, periodically occurring “lumbago” in a problem area may be signs of herpes zoster
   .
   Localization of a herpetic infection
   in the mouth can be manifested by suffering in the upper or lower lip, tip of the tongue, mucous membrane of the cheeks, and palate. In addition to the fact that with herpes the tongue or an area of ​​facial skin goes numb, this infection, even affecting relatively small areas, can result in a violation of the general condition of the body (high temperature, malaise, fatigue, decreased performance);
8. The color of the oral mucosa changes, painful ulcers form, the tongue hurts and goes numb when a fungal infection
   (candidiasis, thrush) spreads in a given place and stomatitis develops;
9. Injuries
   to the facial and masticatory muscles, previous dental and plastic
   surgeries
   ,
   fractures
   and
   dislocations
   can have consequences such as numbness of the head, face, tip of the tongue and other areas located near the affected cranial nerve;

If, with the feeling that your tongue is going numb, you begin to feel dizzy, weakness appears, and numbness in your arms, legs, or other parts of the body is added, there is a danger that this is associated with the development of a serious pathology: transient ischemic attack, pre-stroke, multiple sclerosis, brain tumor, or malignant anemia (megaloblastic anemia).

Video: cervical osteochondrosis as a cause of facial numbness

"Impatient" language

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For no apparent reason, this muscular organ is somehow not subject to numbness. It’s another matter if he turns out to be too “curious” or other (not very terrible) reasons make him numb.

1. More often, the tongue of children who are learning about the world around them becomes numb,
   although they may not say so.
   They taste life in the literal and figurative sense: they can’t wait for the tea or soup to cool down, or out of curiosity they try with the tip of their tongue a metal surface sparkling in the winter sun - such numbness goes away in a couple of days, when the mucous membrane is completely restored. Adults
   sometimes behave like children when the tip of the tongue becomes a kind of analyzer;
2. The tongue goes numb due to the improper use of certain medications
   (why it is recommended to swallow chlorpromazine and libexin whole and not chew it) or prolonged and also improper use of medications containing hormones and intended to relieve attacks of bronchial asthma (various types of inhalers);
3. The tongue goes numb, the sense of smell and taste of smokers changes for the worse,
   so the profession of a taster is clearly not in danger for them, but they only have themselves to blame.
4. Not only the tip of the tongue, but the entire organ becomes numb and refuses to fulfill its functional purpose in the dental chair after the introduction of an anesthetic (Novocaine, Ultracaine) for the purpose of tooth extraction or other operations;

Numbness that has one of the above reasons and disappears when it is eliminated is not a pathological condition and does not require the help of a doctor. Here a person helps himself and draws conclusions about what is possible and what is not: damage to the tip of the tongue in the cold, as a rule, happens only once in a lifetime, but sooner or later everyone goes through this.

In conclusion, I would like to remind the reader that many episodes of numbness are a signal for action. Often, a transient ischemic attack is manifested by a short-term decrease in sensitivity and may soon be forgotten, however, today is a TIA, and tomorrow is a stroke, so if there are concerns that the numbness is associated with problems in the head, you should immediately call an ambulance, because acute cerebrovascular accident (stroke) ) can also happen on the way to the clinic.

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.

Symptoms of neurosis

Pathology manifests itself both at the physical and psycho-emotional levels. Physical symptoms include increased sweating, rapid heartbeat, chest pain and dry mouth, headaches, blurred vision, tremors of the limbs, skin rashes, and menstrual irregularities in women.

Psychological symptoms: a feeling of loss of control, a feeling that the person is “going crazy”, fear of sudden death, excessive worry, high sensitivity and vulnerability.

• Irritability;
• Constant feeling of fatigue and apathy;
• Increased sensitivity;
• Social isolation;
• Frequent and unexpected mood swings;
• Disturbances in sleep and wakefulness;
• Loss of interest in life or certain areas of it.

It is the constant feeling of anxiety for one’s life or the lives of loved ones that causes insomnia in a person. Problems with sleep do not allow the body and nervous system of those suffering from neurasthenia to fully rest. This, in turn, further intensifies all the symptoms listed above.

Therefore, for insomnia, experts recommend several simple and effective rules:

• Follow a daily routine, that is, try to fall asleep and wake up at the same time;
• Play sports, giving the body a light load;
• Be in the fresh air more often;
• Reduce the number of drinks containing caffeine;
• Eat light foods to avoid stomach discomfort.

For what reasons does neurosis develop?

• Strong mental activity;
• Prolonged psychological distress and anxiety;
• Psychological pressure due to the inability to solve life problems;
• Long-term loneliness and problems in the personal sphere of life;
• Traumatic event in life: loss of a loved one, difficult divorce, difficult financial situation, if the person has been subjected to emotional and physical abuse, etc.;
• High expectations. In this case, the person cannot achieve the desired goal and experiences a feeling of an impossible plan;
• Psychological trauma received in childhood: humiliation or beating from peers and parents, example of a bad lifestyle from adults, harsh upbringing;
• Failure to comply with work and rest schedules.

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.

Why do limbs become numb normally?

The reasons for tingling and the feeling that some area has become “foreign” in healthy people arise primarily from their behavior and the situations in which they, of their own free will or at the whim of others, found themselves:

• When standing for a long time
  on a crowded bus, even people who know nothing about varicose veins and venous congestion can feel their toes going numb. Something similar happens if you hold onto handrails for a long time, which are located at a sufficient distance (you have to reach), hold the telephone receiver for hours without changing your ear and hand, or try to hang curtains from the ceiling (hands linger for a long time above the level of the heart), however, in such cases, problems arise in the upper extremities - the fingers go numb;
• A gaze fixed on the monitor, tense muscles of the face and neck,
  rapid hits on the keyboard, an inability to react to others are signs that a person is immersed in a computer game or carried away by an interesting job. When he descends “to the sinful earth,” he will discover numbness in the tips of his fingers, or even the entire hand, suffering in the gluteal muscles and tingling in the legs. Occupation is perhaps one of the most common causes of hand numbness. Performing monotonous movements day after day with hands raised above the heart, a person dooms his limbs to a constant lack of the required amount of blood, which will certainly sooner or later result in their numbness. After some time, the work associated with carrying heavy loads becomes noticeable, as well as work involving mental tension, anxiety, and stress;
• Numbness of the toes and hands in frosty weather
  indicates that the limbs are asking for warmth, where they will quickly warm up and come to life. An area of ​​the face that has turned white and numb in the cold can become frostbitten if measures are not taken in time.
• Sound, healthy sleep often involves lying in one position,
  which does not fully ensure the movement of blood in compressed areas. Numbness of the hands, the back of the head, or some area of ​​the face during sleep is not such a rare phenomenon, which requires taking a break from pleasant dreams and massaging the numb surface.

Healthy people's hands go numb at night because the weight of the body or uncomfortable tight clothing compresses the blood vessels, and the hand comes away after the person releases it and thus restores blood flow.

A person cannot always prevent unpleasant tingling and numbness, but he must strive for this. After all, it’s not difficult to worry in advance about comfort during sleep, choose comfortable bedding (preferably orthopedic), put on soft, luxurious pajamas, and take a comfortable position.

You should treat a walk in sub-zero weather in the same way: if you expect to stay in the cold for a long time, you need to choose the right clothes and shoes.

It is somewhat more difficult for people performing work that constitutes their functional responsibilities, however, here too you should try to alternate static loads with exercises that restore blood flow.

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.

Numb hands keep you from sleeping

Even healthy people can get numb hands during sleep: by placing their left or right hand under their head and deeply immersed in the world of dreams, a young body can sleep through the night without ever turning over to the other side. Moving the limb and lightly rubbing it quickly returns it to normal and the unpleasant sensations are forgotten. It’s another matter when your hands systematically go numb at night, when a tingling feeling appears in the daytime, when others are added to this symptom: pain, weakness, cramps. There are different options for numbness of the upper extremities, each of which may indicate a specific pathology:

diagram of the nerves of the hand, compression of which is possible due to osteochondrosis and other reasons

• Your hands go numb at night, and during the day you suffer from pain in the head, neck, back (and periodic numbness if you stay in one position for a long time) with osteochondrosis of the cervical spine
  and herniated intervertebral discs
  ;
• The cause of numbness in the thumb may be a
  hemangioma or
  neurofibroma
  , which compresses the nerve endings, as well as a compressive effect on the median nerve passing through the carpal tunnel (
  carpal tunnel syndrome
  ).
  Meanwhile, if the thumb “does not come to its senses” for half an hour or more, you should not postpone a visit to the doctor, otherwise its muscles may even atrophy
  ;
• ulnar nerve neuropathy
  occurs . Some patients may not even know that they have this pathology. The disease develops imperceptibly in those people who are forced to rest their elbow on a hard surface for a long time and thus compress the ulnar nerve (a computer desk, for example), moreover, right-handed people often put stress on their right hand, and in left-handed people their left hand goes numb;

• 
  Hands go numb at night, there is pain in the hand, fingers become “wooden” (one or 4, because the little finger is not involved here) in case of median nerve neuropathy or carpal tunnel syndrome
  . The most likely cause of pathological changes may be old bruises and fractures, as well as inflammatory processes localized in this area (arthritis and arthrosis). Often a similar picture is caused by edema caused by pregnancy or decreased thyroid function (hypothyroidism);

• The symmetry observed in numbness of the fingers and hands is characteristic of polyneuropathy
  (
  a complication of diabetes mellitus
  ). By the way, with polyneuropathy, not only the fingers of the upper extremities suffer; the toes often go numb, and, in addition, the surface of the foot can be affected anywhere with the development of the corresponding syndrome.

• vascular causes of numbness - spasm or damage to arterioles

  They lose their natural color (turn white or blue), become cold to the touch, and the fingers hurt and go numb when blood circulation in the microvasculature is impaired, caused by a sharp spasm of blood vessels. This most often occurs in Raynaud's disease and scleroderma

  ;

• It should be noted that chronic alcoholism and
  severe poisoning also contribute to the appearance of signs of polyneuropathy, namely, numbness of the fingers and toes during sleep and in reality;
• Of particular concern are cases when only the left hand
  and, especially, its thumb are numb, which is most often associated with the development of atherosclerosis, cardiac pathology, osteochondrosis of the cervical and/or thoracic spine. But if the loss of sensation in the thumb of the left hand mainly suggests diseases of the cardiovascular system, then numbness and other symptoms regarding the right hand are perceived as a suspicion of cervical spondylosis, which, however, does not affect young people;
• Heart problems
  by numbness in the little finger of the left hand, and if it stops showing “signs of life” together with the ring finger, then it is time for the patient to think about a visit to a cardiologist.

If both arms go numb at the same time or an unpleasant tingling sensation is localized in a specific area of ​​the left or right arm, or affects the hands or fingers, and the clinical picture is diluted by additional symptoms (weakness, pain, numbness of other parts of the body), the thought of development of the above-mentioned serious diseases (multiple sclerosis, neoplastic process). If this happens suddenly, then a TIA or stroke can be suspected.

Looking for a reason

Each person has pain and numbness in his own way and, probably, not all options for numbness in the fingers have been considered, however, if stiff limbs are increasingly waking you up at night, and a person cannot find an explanation for this, then perhaps a short list of reasons will help him that cause these unpleasant sensations:

1. Professional activity;
2. Osteochondrosis of the cervical and thoracic spine;
3. Intervertebral hernia;
4. Iron deficiency in the body;
5. Endocrine diseases;
6. Inflammation of the pancreas;
7. Pathological changes in joints;
8. Venous stagnation;
9. Arterial hypertension;
10. Sharp spasm of microcirculatory vessels;
11. Polyneuropathy.

In addition, to determine the true cause of hand numbness, you should pay attention to other symptoms that accompany these unpleasant, and sometimes painful, episodes:

• Weakness of the hand;
• Low contractility of the muscular system;
• Possible pain in the shoulder and forearm;
• Fatigue, malaise, bad mood;
• Dizziness;
• Heaviness in the head, noise in the ears;
• Inconsistency of movements;
• Unstable blood pressure (jumps and falls);
• Impaired functioning of the vestibular apparatus;
• Flashing "flies" before the eyes.

Some of the listed diseases and their symptoms can cause your toes to go numb, so it’s time to talk about this too.

Video: hand numbness

Video: 3 reasons for hand numbness in the “Live Healthy!” program