From the Guidelines
Yes, Multiple Sclerosis (MS) can cause nerve tingling in the face, as the disease can affect the trigeminal nerve or its pathways in the brain stem, leading to facial paresthesia. This sensation occurs when MS lesions disrupt normal nerve signal transmission, causing patients to experience tingling, numbness, burning, or pins-and-needles sensations in parts of the face 1. The trigeminal nerve is responsible for facial sensation, and when myelin damage from MS affects this nerve, patients may experience these sensory symptoms, which can affect one or both sides of the face and may come and go during MS relapses or become persistent in some cases.
Some key points to consider include:
- MS is a demyelinating disease that affects the central nervous system, including pathways that control facial sensation 1
- Facial tingling might be mistaken for other conditions like Bell's palsy or trigeminal neuralgia, so it's essential to report these symptoms to a neurologist 1
- Management typically involves treating the underlying MS with disease-modifying therapies, while symptomatic treatments might include medications like gabapentin, pregabalin, or carbamazepine if the sensations are painful or disruptive 1
- The facial nerve (CN VII) can be affected by intra-axial conditions such as infarction, vascular malformations, tumors, and multiple sclerosis, leading to various symptoms, including facial paralysis and hemifacial spasm 1
In terms of treatment and management, it's crucial to address the underlying MS with disease-modifying therapies and consider symptomatic treatments for painful or disruptive sensations. Treating the underlying MS and managing symptoms are essential to improve quality of life and reduce morbidity and mortality. By understanding the relationship between MS and facial paresthesia, healthcare providers can provide more effective care and support for patients experiencing these symptoms 1.
From the Research
Nerve Tingling in the Face and Multiple Sclerosis
- Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system that can cause a wide range of neurological symptoms, including nerve tingling in the face 2, 3, 4, 5, 6.
- Studies have shown that MS can present with facial symptoms and signs, such as facial palsy, myokymia, and hemifacial spasm, which can be the first manifestation of the disease 3, 6.
- Facial numbness is a common symptom of MS, and neurophysiological studies have shown that it is often related to abnormal trigeminal somatosensory evoked potentials (TSEPs) and blink reflex (BR) 4.
- The "numb chin syndrome" is a rare presentation of MS, characterized by isolated hypesthesia on one side of the chin and lower lip, and can be the first presenting syndrome of the disease 5.
- Research has found that facial involvement in MS is not uncommon, with a prevalence of 3.27% for facial palsy, 1.28% for myokymia, and 0.84% for hemifacial spasm in a cohort of 2260 MS patients 6.