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Facial numbness in the ophthalmology clinic. A portentous sign

PainSci » bibliography » Ugradar et al 2020

Three articles on PainSci cite Ugradar 2020: 1. The Complete Guide to Chronic Tension Headaches2. The Complete Guide to Neck Pain & Cricks3. When to Worry About Neck Pain … and when not to!

PainSci notes on Ugradar 2020:

This paper reports on fourteen people with facial numbness who sought care at an opthamology clinic (eye doctor). In all fourteen cases, facial numbness proved to be a symptom of serious illness, mostly skin cancers spreading along nerves, and some infections. Nine of these patients eventually died, and the remainder all had a rough ride: “significant morbidity.”

Why did this study come from the world of eye medicine? Because some of the same things that cause eye trouble also cause facial numbness — and/or headaches and neck pain, which is why this might be of interest to some readers.

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

AIM: To report a case series of 14 patients presenting with facial numbness primarily to the ophthalmology clinic.

METHODS: All patients presenting with facial numbness to the ophthalmology clinic at the University of California, Los Angeles, were reviewed for study entry between 1993 and the present. Patients with a history of trauma or surgery were excluded.

RESULTS: Fourteen patients (eight females and six males) presented to the ophthalmology clinic with numbness. Nine patients (64%) presented primarily with numbness. This symptom was associated with mortality (57%) and significant morbidity. The most common cause was neoplastic pathology (n = 10, 71%), with perineural spread from squamous cell carcinoma being the most common (five cases, 36%). The remaining cases were related to infection (n = 4, 29%).

CONCLUSIONS: Most of the patients presenting to our service with numbness eventually died due to their condition. Given the poor prognosis of the patients in our case series, numbness of the face may be a portentous sign and therefore warrants a thorough examination with close follow up.

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