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What Causes Numbness On Left-sided Face After Taking A Novocaine Injection?
Question: Today at lunch, I noticed that the left side of my face was a bit on the numb side and my mouth felt like I had a Novocaine injection for dental work as the left side of my lip felt numb and I had a hard time drinking from a glass as I could not feel the left side of my lip. My left eye is tearing a lot as well as the eyelid not being able to close all the way. Please advise
Brief Answer:
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
Judging from the description of your symptoms, especially the last part about not being able to close the eye all the way, I believe the cause of your symptoms is left facial nerve paralysis, or Bell palsy as it is commonly called. It is due to damage to the left facial nerve, the nerve responsible for the innervation of the face on that side.
Most cases are idiopathic, meaning with no apparent origin (but it is hypothesized it may be due to a viral infection such as the herpes virus). In your case though you have a possible causing mechanism which is diabetes. Diabetes can damage the small blood vessels which supply the nerve.
Most cases improve spontaneously, about 80-90% return to normal in about 6-12 weeks. Of course the younger the patient and the fewer accompanying condition the higher the chances of recovery, in your case may be a little lower looking at the long list of medications you take, in particular the fact you have diabetes.
In terms of treatment the chances of recovery are thought to be higher by treatment with corticosteroids and antivirals. In your case though I do not think they should be used as if the damage is due to diabetes, so antivirals wouldn't be of much use while corticosteroids may increase your blood glucose. So only artificial tears to protect the eye and perhaps a vitamin B containing combinations may be used (though their efficacy is not proven).
While I am fairly confident in my diagnosis I still believe you should see a physician in order to confirm the findings of facial muscle weakness as well as to check for other neurological signs you might have missed which might indicate another cause for facial palsy such as stroke or infection.
I remian at your disposal for other questions.
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
Judging from the description of your symptoms, especially the last part about not being able to close the eye all the way, I believe the cause of your symptoms is left facial nerve paralysis, or Bell palsy as it is commonly called. It is due to damage to the left facial nerve, the nerve responsible for the innervation of the face on that side.
Most cases are idiopathic, meaning with no apparent origin (but it is hypothesized it may be due to a viral infection such as the herpes virus). In your case though you have a possible causing mechanism which is diabetes. Diabetes can damage the small blood vessels which supply the nerve.
Most cases improve spontaneously, about 80-90% return to normal in about 6-12 weeks. Of course the younger the patient and the fewer accompanying condition the higher the chances of recovery, in your case may be a little lower looking at the long list of medications you take, in particular the fact you have diabetes.
In terms of treatment the chances of recovery are thought to be higher by treatment with corticosteroids and antivirals. In your case though I do not think they should be used as if the damage is due to diabetes, so antivirals wouldn't be of much use while corticosteroids may increase your blood glucose. So only artificial tears to protect the eye and perhaps a vitamin B containing combinations may be used (though their efficacy is not proven).
While I am fairly confident in my diagnosis I still believe you should see a physician in order to confirm the findings of facial muscle weakness as well as to check for other neurological signs you might have missed which might indicate another cause for facial palsy such as stroke or infection.
I remian at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr. Taka:
In regards to your analysis above, you were spot on as I went to the local emergency room and the doctors there also concluded that it was Bell Palsy. The doctor there understood that I am a diabetic, but still believes that a Corticosteroid pack would be the best course of action. She said that I should just be cautious of my blood glucose and check it frequently. They did a CT scan to be on the safe side and the results was it was clean and my blood work came back normal except for my blood glucose. I told them that I ate not too long ago prior to that so she took that with a grain of salt.
She also stated that because I caught it fairly quick, the problem with the eye as well as the problem with the lips should recede quickly and the symptoms were already starting to recede while I was in the emergency room. My eye was the most noticeable as the swelling was going down. I will notify you when all symptoms have gone away.
In regards to your analysis above, you were spot on as I went to the local emergency room and the doctors there also concluded that it was Bell Palsy. The doctor there understood that I am a diabetic, but still believes that a Corticosteroid pack would be the best course of action. She said that I should just be cautious of my blood glucose and check it frequently. They did a CT scan to be on the safe side and the results was it was clean and my blood work came back normal except for my blood glucose. I told them that I ate not too long ago prior to that so she took that with a grain of salt.
She also stated that because I caught it fairly quick, the problem with the eye as well as the problem with the lips should recede quickly and the symptoms were already starting to recede while I was in the emergency room. My eye was the most noticeable as the swelling was going down. I will notify you when all symptoms have gone away.
Brief Answer:
Read below
Detailed Answer:
Thanks for the update. Good to know that the diagnosis was correct.
Personally I wouldn't prescribe prednisone in a diabetic as most patients improve anyway, but it is a debatable issue, opinions vary among physicians so I can't say that I'm definitely right and she's wrong, go on with it and keep an eye on blood sugar levels as was recommended.
If the symptoms are already a little bit better then I agree that it is a reason to be optimistic of achieving full recovery, usually in the first few days the deficits worsens, so if development has stopped already is a very good sign.
Wishing a speedy full recovery.
Read below
Detailed Answer:
Thanks for the update. Good to know that the diagnosis was correct.
Personally I wouldn't prescribe prednisone in a diabetic as most patients improve anyway, but it is a debatable issue, opinions vary among physicians so I can't say that I'm definitely right and she's wrong, go on with it and keep an eye on blood sugar levels as was recommended.
If the symptoms are already a little bit better then I agree that it is a reason to be optimistic of achieving full recovery, usually in the first few days the deficits worsens, so if development has stopped already is a very good sign.
Wishing a speedy full recovery.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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