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Suggest Remedy For Facial Tightness After Taking Alcohol

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Posted on Thu, 16 Apr 2015
Question: After a night of alcohol and stress and tiredness i woke up to one sided facial tightness. The right side doesnt look the same anymore. However, my neurologist said my face looks symmetrical. Was just wondering could this be caused by a virus if i woke up with it? or could i have compressed nerve in sleep? and will it go back to normal. teeth are normal, blood tests and mri is normal. also my cheek just feels puffy like theres more skin.... i dont know if its because its drooped slightly or because its puffy. i just want it back to normal. everytime i touch the right side of my face i can feel a nerve in my tooth. i just have a constant 24/7 pressure sensation feeling. i just want it to go away. Can botox help make my face look better?
doctor
Answered by Dr. Dr. Matt Wachsman (22 minutes later)
Brief Answer:
several possibilities

Detailed Answer:
a pure sensory stroke of a very very small area is very unlikely.
that is a very common area to have sensory irritation though. First, there is BELL'S palsy from the nerve that goes under the jaw to most of the face getting pinched or irritated. It controls both sensation and motion and goes over a wide area of the face. Minor irritation of it would be "just feels funny" can get worse before it gets better. Almost always gets entirely better.

Then the part of the brain thaty gives sensation to different parts of the face (top, middle or loweer face... three different parts) the trigeminal nerve can get irritated. Commonly by the virus that gives cold sores (herpetic neuralgia) or the closely related virus that gives shingles (shingles of the face). These occur rapidly and resolve rapidly.

If it is JUST the jaw, and is triggered/made worse with opening the mouth then it can be temporal mandibular syndrome. Similar to the Bells but very localized and triggered by trauma such as sleeping on it wrong. This.... is nearly always PAINFUL and varies on how long and if it gets better.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Matt Wachsman (9 minutes later)
It happened after a lot of alcohol i keep thinking is it possible to compress trigeminal nerve jn sleep? Or could it be from too much alcohol? Or is it possible to have a minor bells palsy? Like grade 1

been like this fr 6 months
doctor
Answered by Dr. Dr. Matt Wachsman (9 hours later)
Brief Answer:
trigeminal nerve

Detailed Answer:
is inside the skull very deep. The facial nerve runs VERY EXPOSED around the outside of the jaw, just under the earlobe. Oh sure, easy to have a minor bell's.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Matt Wachsman (4 hours later)
when will it resolve

can too much alcohol cause it
doctor
Answered by Dr. Dr. Matt Wachsman (2 hours later)
Brief Answer:
some thoughts

Detailed Answer:
First, cannot diagnose, or treat without directly observing, but can give general information.
There are a few different alcohol related neuropathies. This is not one of the ones in the textbook. Lack of taking in thiamine can cause a brain degeneration. It is associated with eye abnormalities and dementia. Not facial symptoms. There is peripheral nerve problems associated with alcohol...this causes numbness in the longest (not the shortest) nerves.

And then, there is newlywed arm. In this, someone gets drunk and either sleeps on an exposed arm nerve or classically has one's newlywed sleep on ones arm and the nerve acts like it is asleep. It recovers in months. This is possible with sleeping in a position that puts pressure on the exposed facial nerve.

I've had alcoholics with Bell's palsy, while it could be an entire coincedence, there are several ways alcohol can injure nerves. It recovers as any other Bell's palsy in a few months.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Matt Wachsman (6 minutes later)
If i slept on it will it recover? Because its been 6 months and no change
doctor
Answered by Dr. Dr. Matt Wachsman (45 minutes later)
Brief Answer:
6 months is a long time

Detailed Answer:
nerve conduction studies (quite painful) would show if there is a problem and distinguish between sick nerves and pinched nerves.

But... at 6 months.... you'd expect recovery to have occurred if it is going to unless the pinch is still present. I've never heard of a Bell's palsy being surgically corrected, but less than complete recovery happens--sometimes it gets nearly all better but not 100%.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Matt Wachsman (11 minutes later)
I've attached two images of me before the night of alcohol and me after. The hair up is before and hair down is after. My eye looks bigger and I dunno it just looks weird. Also can trigeminal neuropsthy cause puffiness or swelling
doctor
Answered by Dr. Dr. Matt Wachsman (23 minutes later)
Brief Answer:
sorry cannot say

Detailed Answer:
I have two identical images. Something went wrong in the upload somewhere, but there are only two images with the same name and looking identical; I suspect they are all the before image even though the hair is loose. Obviously it is difficult to say much with only one image, which is of ONE side of the face. the after view including both sides of the face would be helpful.

Other neuropathies to consider are lyme disease, b12 deficiency, thyroid disease, a growth/malformation or other thing impinging on the facial nerve. Nerve conduction studies can show an abnormality but not the cause.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Matt Wachsman (4 hours later)
I just want to look nice again. But this nerve tightness has altered the way i look i cant take it will it resolve. ?

What's best medication to reduce puffiness
doctor
Answered by Dr. Dr. Matt Wachsman (4 hours later)
Brief Answer:
ah, I see

Detailed Answer:
assuming the other side is NOT swollen.. then.. you'd have to wonder about infection. Looking at lymph nodes would be a first step. Dental exam. Some odd diseases such as lyme, various animal diseases,

Then... let us assume there is nothing wrong (because if it's an infection, then antibiotics can just fix things .. including dental infection). Then.... warm soaks twice a day would be the first. various spa treatments for shrinking the skin would also possibly work (wraps, soaks, etc.).
these work, if at all, very fast... few days.
Note: In case of any other concern or query related to prevention, evaluation, diagnosis, treatment, or the recovery of persons with the any type of addiction or substance use, follow up with our Addiction Medicine Specialist. Click here to book a consultation now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 4214 Questions

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Suggest Remedy For Facial Tightness After Taking Alcohol

Brief Answer: several possibilities Detailed Answer: a pure sensory stroke of a very very small area is very unlikely. that is a very common area to have sensory irritation though. First, there is BELL'S palsy from the nerve that goes under the jaw to most of the face getting pinched or irritated. It controls both sensation and motion and goes over a wide area of the face. Minor irritation of it would be "just feels funny" can get worse before it gets better. Almost always gets entirely better. Then the part of the brain thaty gives sensation to different parts of the face (top, middle or loweer face... three different parts) the trigeminal nerve can get irritated. Commonly by the virus that gives cold sores (herpetic neuralgia) or the closely related virus that gives shingles (shingles of the face). These occur rapidly and resolve rapidly. If it is JUST the jaw, and is triggered/made worse with opening the mouth then it can be temporal mandibular syndrome. Similar to the Bells but very localized and triggered by trauma such as sleeping on it wrong. This.... is nearly always PAINFUL and varies on how long and if it gets better.