What could be causing numbness and tingling in my left cheek and left arm?

Urgent Stroke Evaluation Required

You need immediate emergency department evaluation NOW—this combination of left-sided facial and arm numbness represents a potential stroke, which has a 10% risk of completion within the first week (highest in the first 48 hours), and requires intervention within minutes to hours to prevent permanent disability or death. 1, 2

Why This Is a Medical Emergency

• The combination of facial numbness with left arm symptoms has a 72% probability of stroke when accompanied by facial weakness or speech disturbance 1
• Even isolated hemibody sensory loss (numbness on one side) represents high stroke risk and requires same-day assessment 1, 2
• Patients presenting within 48 hours with unilateral numbness are at HIGH RISK for recurrent stroke 2

What Will Happen in the Emergency Department

Immediate Physical Assessment (First 5 Minutes)

The emergency team will check specific findings to differentiate stroke from acute arterial occlusion:

• Check both radial pulses and blood pressure in both arms immediately—a blood pressure difference >20 mmHg between arms confirms significant arterial compromise requiring immediate vascular surgery 1, 2
• Assess the "6 P's" of acute limb ischemia: Pain, Pallor, Pulselessness, Paresthesias (your numbness), Poikilothermia (cool limb), Paralysis 1, 2
• Perform Cincinnati Prehospital Stroke Scale: facial droop, arm drift, and abnormal speech 1

Emergency Imaging (Within 30-60 Minutes)

• Brain MRI with diffusion-weighted imaging is the preferred test to detect acute ischemic changes and must be performed immediately 1, 2
• If MRI unavailable, CT head without contrast to rule out hemorrhage 1, 2
• CT angiography or MR angiography from aortic arch to vertex to evaluate carotid and vertebral artery disease 2
• Carotid ultrasound to identify extracranial carotid stenosis >70% requiring carotid endarterectomy 1, 2

The imaging differentiates ischemic from hemorrhagic stroke, which fundamentally changes treatment 1, 2

Treatment Based on What They Find

If Stroke/TIA is Confirmed:

• Dual antiplatelet therapy (aspirin + clopidogrel 75 mg) for the first 21 days in patients with symptomatic carotid stenosis not undergoing revascularization, followed by long-term single antiplatelet therapy 1, 2
• Comprehensive clinical evaluation by a healthcare professional with stroke expertise within 24 hours 2

If Acute Arterial Occlusion is Found:

• Immediate vascular surgery consultation for thrombectomy/embolectomy—outcome depends entirely on time to reperfusion 1, 2

What This Is NOT

• This is NOT trigeminal neuralgia, which presents with paroxysmal attacks lasting seconds to minutes with sharp, shooting electric shock-like pain, not continuous numbness 1
• Continuous facial numbness combined with arm numbness is more consistent with stroke than peripheral neuropathy or other benign conditions 1

Critical Time Window

You must be evaluated within 24 hours of symptom onset to receive comprehensive stroke prevention treatment and reduce your 10% risk of completed stroke in the first week 1, 2, 3

Do not wait—go to the emergency department immediately or call 911.