Facial Numbness

[Lenore58]

Having an odd symptom and wondering if you kind folks have any insights. About a week ago, I noticed numbness around my eyebrows and forehead. It was so subtle at first that I wondered if I was imagining it. But now if I touch my eyebrows I can barely feel them. I am wondering if this could be associated with GCA or a side effect of Actemra or prednisone?

[PMRpro Ambassador]

Please see a doctor about facial numbness, especially if it is worsening - it can be a symptom of several things including stroke. You need to be properly examined.

[Temoral in reply to PMRpro]

I did go to GP with numbness in and around lips. He said it was not likely to be linked to stroke risk as it was not down one side only. Has done a range of blood tests for, vitB deficiency, thyroid...awaiting phone call now for results...meanwhile I have taken some magnesium supplement as read that this can also be a cause. I will relate blood results when they come in.

[PMRpro Ambassador in reply to Temoral]

Less likely yes - but bilateral strokes do happen. Sometimes there is a zebra amongst the horses ...

flintrehab.com/bilateral-st...

[Temoral in reply to PMRpro]

Good info...but is the tingling/numbness leading to a possible stroke, or indication of having had one, with no other indications. Reading past posts on here, even up to 4 years ago, suggest that some people have numbness and tingling as a general symptom of GCA or pred, throughout their journey...more confusion in this very individualised condition it seems....still waiting for blood results call...

[PMRpro Ambassador in reply to Temoral]

It is confusing - I was just pointing out his logic was flawed and he could miss a patient having a stroke. And actually - GCA can cause pre-stages of a stroke, in the same way angina can be a herald of cardiovascular problems.

[Temoral in reply to PMRpro]

Yes indeed...always best to be on the safe side. Blood results show slightly low folic acid...and he said just get the cheap Teso version to boost it, then retest in 4-6 weeks.

[PMRpro Ambassador in reply to Temoral]

Just watching an ambulance programme - elderly patient with really severe one-sided weakness and the daughter queried stroke, A carer responder (I think) said it couldn't be a stroke as he had no facial droop so he was left all weekend with it getting worse. Not all patients present like a textbook ...

[Lenore58]

Thank you for replying PMRpro and for sharing your experience Temoral.

I noticed in the middle of the night that it had lessened. This morning too; it is milder. Also last night I read that it could be caused by hypothyroidism. I’ve been on levothyroxine for years for that. My blood test for that was off a couple weeks ago. Both TSH and Free T-4 were elevated. That has never happened before. (Both elevated is unusual. Typically if TSH is high, T4 is low.) My doctor said T4 isn’t as sensitive and that the TSH shows my thyroid is low. We discussed upping my medication. (I take 150 mcg., which isn’t a small dose!) In the end we decided to try me being more careful with taking it 30 minutes before eating or having coffee to see if that helps, and retesting in 6 weeks. Now I am wondering if that’s a bad plan. I’m still having mild positional vertigo/dizziness. That can be a symptom too.

Sigh. Aging is such a challenge! All sorts of unwanted mysteries to solve! My intuition tells me its not a stroke; but who knows. I’ll call my PCP, but it’s very hard to get in. They’ll probably tell me I have to go to urgent care.

[PMRpro Ambassador in reply to Lenore58]

All the best - though surely even if you are on 150mcg, the TSH being high shows it still isn't enough ...

[Almostaweed]

Hi Lenore58, Not sure if this is relevant, but I am thyroxine and Prednisolone and also Omeprazole to protect digestive system from the Pred. I have to be very careful to take the thyroxine about 45 mins before the Omeprazole. If I don't leave that gap I find that the Omeprazole weakens the effect of the thyroxine and I feel hypothyroid.

[Crusty1949]

I was on prednisone for almost four years and never experienced facial numbness. I would be giving my doctor a call and have him address the issue. Numbness is not something you want to ignore.

[Dydee]

Sorry I'm late to the party but just trying to catch up on emails. Just to put in my 2 cents worth, I have been on Prednisone for 4 years with PMR and Levothyroxine for over 45 with added Liothyronine about 5 years ago. I have never had any numbness or tingling anywhere, even when my thyroid tests came back a little wonky and doc adjust my meds. Hope you get to the bottom of things.