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Conditions and Diseases > Ear, Nose and Throat Disorders Forum > Facial numbness and lump near occipital region
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Q: Facial numbness and lump near occipital region
asked by: DoctorQuestion on November 10th, 2006
I was involved in a low impact MVA about 2 months ago. I am just about to return to work now. I had alot of neck and facial pain immediately following the accident. My Doctor put me on muscle relaxants and pain meds along with Ativan to keep me from being to anxious about my condition. During the first month I had alot of pressure at the base of my neck (C1 region). It felt like intense sinus pressure but it was coming from the base of my skull. I noticed a lump on the right side of my neck around the occipital region two days after the injury. I had facial numbness from the top of my right cheekbone down the side of my face and along the mandible to the midline. My smile was obviously shifted to the left with a weakness in the facial muscle on the right. I had ear pain, similar to the ache you get when you eat something sour. Sensitivity to sounds. Alot of difficulty swallowing, followed by instant reflux. And a difference in my taste sensation. I have seen an orthopedic surgeon, there is no fracture. I have seen a neurologist, he noted only the weakness in the mental nerve region(my doctor was worried about Bells Palsy). I also saw a chiropractor who took his own series of xray and told me that the C1 was tipped and rotated towards my throat on the right side. None of my professionals like Chiropractic so I have not pursued treatment. I was getting better until this week when I tried to work on my computer in anticipating returning to work. The lump never went away but now it is bigger. It was not tender before but is becoming so now. My facial numbness is returning and my high cheekbone is burning. I am having problems swallowing again. My doctor is now sending me to see a ENT in six weeks. I am on the list for an MRI. Should I be pushing for more tests. I do not know what this is. He is concerned about the parotid gland. I want to be safe and make sure my doctors are covering all the possibilities. Can you give me some direction please. Thank-you.


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Dr. Nikola Gjuzelov , MD
replied on November 30th, 2006
Ear, Nose & Throat Disorders Answer A1854
Some of the symptoms you describe (smile shifted to the left with a weakness in the facial muscle on the right and difference in your taste sensation) could be due to Bell’s paralysis of the right facial nerve... but only if you can’t close your right eye. If you can close your right eye, then you are probably not experiencing Bell’s paralysis (peripheral facial nerve failure), but perhaps a central facial nerve failure. Eventual central facial paralysis combined with facial numbness and burning and difficult swallowing with reflux might suggests that something is happening in the head. Another neurological examination together with a CT-scan or MRI of the head might help to clear this case. The lump you mention in the occipital region is third problem that should be diagnosed correctly. A physical examination and an MRI might provide you with more information about it.
You can ask for second opinion from another neurologist and orthopedist. An ENT (ear-nose-throat) specialist is also needed to check that lump on the neck.



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