Hello there, hopefully someone will have an answer for me. A few weeks ago I was minding my own business in a bar when suddenly a drunk guy punched me in the face for no reason. As a result, I had a swollen cheek, and barely could open my mouth for a week. After the swelling went down, I started feeling a numbness in my face. From the bottom left side of my chin to the begining of my cheek. Its a very specific area. At first the numbness would last 15 minutes and then go away, and would do so 3 or 4 times a day. But now for the past 5 days it has been constant Does anyone know what can cause this, and if there is anything to do to get rid of this? Or is it only time that will cure this feeling?
You have had some damage to one of the small peripheral nerves that supply the face. There are several nerves around the face, each supplying its own little area.
It is easy for these nerves to be damaged from a direct blow. This can cause the nerve to go to sleep, technically called a neuropraxia. They usually wake up on their own.
However, it is a little strange that the numbness has gotten worse with time and when the swelling went down. It is usually the other way around. The feeling comes back when the swelling decreases. Are you sure that the area was not numb, and that now the area is waking up. When the nerve starts to wake up, it begins to tingle. But anyways, you know your face.
So, if you do not notice the nerve waking up (it will start to tingle first) in the next few days, you might want to have a physician take a look at it. It could be that you actually have a fracture where the nerve comes out of the skull. Or you could be developing scar tissue around the hole where the nerve comes out. There are several things that could be going on.
Thank you for your reply! You seem to know exactly what you are talking about and it is reassuring. Yesterday I went to the dentist and had x-rays done, and he found a small fracture just underneath my bottom wisdom tooth. So from what I read it would make sense that there could be nerve damage due to the fracture. The dentist prescribed some anti-inflamatory and some anti-biotics, but he didn't say if it the numbness will go away. From what you know, is it only once the fracture healed that the nerve will also start to heal and the numbness will go away?
Unfortunately, there is no correlation between the healing of the bone and the healing of the nerve. Though they were both probably caused by the same thing, the direct blow, they heal in very different ways.
The bone has already started to lay down callus. Callus is the new bone formation which will heal the fracture. The body begins to lay this down almost as soon as the bone is broken. Usually, most fractures around the face will heal in a total of about 4-6 weeks. Due to the architecture of the bones and the fact that the fracture was nondisplaced, you should heal this fracture very quickly. Pain is the best guide (besides x-rays) to determine how the break is healing. As the bone unites (knits back together) the pain right over the fracture will decrease. Usually, when the pain is gone, the bone is united.
Now, as to the nerve, when it wakes up is determined by how badly the nerve was injured. If it was just bruised (neuropraxia), then it should wake up very quickly. But, at the other end of the spectrum, it is actually possible for nerves to be cut by the bone at the break. Bone fragments can be very sharp, and actually cut soft tissues. If this occurred, then recovery is very unlikely, if at all. Then, of course, you have the injuries that are somewhere in the middle, that can take up to six months to recover.
you do not say if you have an motor involvement or not. Do you have problems moving some of the muscles around the face? Like when you smile/frown, grin real big, show your teeth, etc? If there is motor involvement, it is more important that the nerve function be regained. While it is nice to be able to feel you face, especially with shaving, caressing, etc, having a numb spot will not affect the functioning of your face muscles.
So, if the nerve does not recover quickly (in a couple of weeks), or if you have motor involvement, you may want to see a maxillofacial surgeon or a plastic surgeon, to see if there is anything that needs to be done about the nerve.
Hope that nerve wakes up real soon. The bone should heal well on its own, as long as you do not injure it again in the immediate future. Good luck.
to answer a few of your questions, I am fully able to move all muscles in the facial area where it is numb. This said, I sure do hope that the nerve is not cut by the bone and that it is just being stubborn! I guess only time will be able to tell. I will give it another week, and if by then there is no improvement than I shall seek a maxillofacial surgeon as you suggest.