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Facial numbness is a Very Serious Symptom

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

I always hesitate before publishing anything “scary.” But some things are legitimately scary…and yet still worth knowing, still worthy of a public service announcement.

Facial numbness strikes me as such a thing, a Very Serious Symptom, one of the reddest of all the red flags, and something we should all be aware of — in the same spirit that we should be aware of the signs of a stroke (FAST!), a heart attack (often subtler than the clichés, especially in women), or diabetic blood sugar crises (not everyone who seems drunk actually is).

Fourteen people with facial numbness 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 — nine! — and the remainder all had a rough ride: “significant morbidity.” See Ugradar et al.

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. I have added this red flag to my books on those topics, and to my when-to-worry guide for neck pain.

So, please never ignore facial numbness. Especially if you have a suspicious skin sore on the head, face, or really anywhere on the upper body. Here’s a good patient’s guide to squamous cell carcinoma.