Essential tremor is a fairly common hereditary disease of the central nervous system that can occur in children, but mainly develops in older people. The only manifestation of this disease is trembling. Tremors with essential tremor have different localization, severity, prevalence, characteristics and age of onset. Tremors of the head, hands, and tongue are most often observed. Lip tremor is slightly less common in adults.
Symptoms
Most often, essential tremor manifests itself as medium-amplitude and small tremors of the hands, alternating contractions of the flexor and extensor muscles, while muscle tone remains the same. Trembling becomes noticeable during purposeful movements; when approaching the target, its persistence or even a slight increase is observed. Rest tremor is much less common.
As the disease progresses, patients become unable to work. They become unable to serve themselves: due to difficulties in holding cutlery, they cannot eat food or drink water from a mug. Patients are unable to perform many activities that are necessary in everyday life; they need help even with buttoning up buttons and other trivial matters.
Due to the layering of emotional disturbances on the manifestations of tremor, patients develop social maladjustment. Hand tremors with essential tremor occur earlier than, for example, trembling of the lip (in adults) and other parts of the body. For a long time, hand tremors remain the only manifestation of the disease. As a rule, simultaneous trembling of both hands is observed, in rare cases - first only one, then the other.
Disorders of facial innervation
A neurotic face may develop due to damage to the nerves that innervate it. Most often these are the trigeminal and facial nerves.
The trigeminal nerve is the 5th pair of cranial nerves. It is the largest of all 12 pairs of these nerve fibers.
N. trigeminus arises symmetrically on both sides of the face and consists of 3 large branches: the ophthalmic, maxillary and mandibular nerves. These three large processes innervate a fairly large area:
- skin of the forehead and temples;
- mucous membrane of the oral and nasal cavities, sinuses;
- tongue, teeth, conjunctiva;
- muscles - chewing, floor of the mouth, palatine, tympanic membrane.
Accordingly, when it is damaged, pathological sensations arise in these elements.
Facial nerve – 7th pair of cranial nerves. Its branches surround the temporal and ocular region, the zygomatic arch, and descend to and behind the lower jaw. They innervate all facial muscles: auricular, orbicularis and zygomatic, chewing, upper lip and corners of the mouth, cheek. As well as the muscles of the lower lip and chin, around the mouth, the muscles of the nose and laughter, and the neck.
N. facialis is also paired, and is located on both sides of the face.
In 94% of cases, the damage to these nerve fibers is unilateral, and only 6% is a bilateral process.
Disruption of innervation can also be primary or secondary.
Primary is the lesion that initially involves the nerve. This could be hypothermia or strangulation.
Secondary damage develops as a consequence of other diseases.
Another reason for the development of facial neurosis is neurogenic and mental disorders. When unpleasant sensations in the face and head occur against the background of psycho-emotional arousal, shock, or as a result of stressful situations.
Various localizations
More than 50% of patients suffer from head tremors. Often, it is from this localization that the disease begins, and later trembling of the limbs occurs. The head most often moves left and right, less often - down and up, in a circle or diagonally.
Quite often, patients suffer from facial muscles - trembling of the lower lip develops in adults when smiling or talking. Tremor can also manifest itself as isolated, rapid, small twitches of the facial muscles. This type of tremor can occur at an early stage of the disease.
In addition, patients may experience mild tremor of the tongue or eyelids.
Elderly and middle-aged patients who have had the disease for more than 10 years may experience a trembling voice. Sometimes this symptom also occurs in younger people (up to 20 years old) with a disease duration not exceeding 5 years.
Almost a quarter of patients experience trembling of the lower extremities.
Trembling of the entire body is observed in rare cases, most often after physical exertion or emotional outbursts. This symptom may indicate the spread of the disease.
In a small number of patients, diaphragmatic trembling is observed, which can be confirmed by x-ray. When a combination of tremor of the tongue, lips, diaphragm and vocal cords occurs, speech and breathing rhythm may be disrupted.
Regardless of location, trembling intensifies with excitement, significant physical exertion, and hypothermia. When drinking alcohol, there is a decrease in tremor, but it intensifies the next day.
There is a childhood and youthful form of tremor, as well as a form of mature and senile age.
The disease is often diagnosed in patients of childhood and adolescence.
Essential tremor is benign: it does not pose a threat to the patient’s life, but it is constantly progressing, so this disease cannot be ignored.
Doctors at the Neurology Clinic of the Yusupov Hospital provide assistance to patients with essential tremor, aimed at eliminating symptoms that significantly worsen the quality of life of patients. The clinic provides high-quality drug therapy and physiotherapeutic procedures that significantly improve the patient’s condition.
Numbness after implantation
One of the most common reasons for decreased sensitivity of the dentition is a violation of the implantation technique, that is, the implantation of an artificial tooth root. The situation can also be aggravated by the introduction of poor-quality anesthesia or nerve damage during an injection with a syringe with an anesthetic composition.
Numbness can also occur when a pin is made of the wrong size and length. As a result, during installation, the doctor accidentally injures the nerve or compresses it too much. Today it is customary to distinguish three stages of tooth numbness due to a doctor’s mistake during an operation to implant an artificial root.
The first stage is neuropraxia. At this stage, there is only slight numbness and decreased sensitivity. Usually all symptoms disappear within a couple of hours after the intervention or after 1-2 days, depending on the individual characteristics of the patient’s body. The second stage is axonotmesis. It is characterized by loss of sensitivity for a month or more. The most difficult case is neurotmesis; numbness can haunt a person for several months.
Treatment
Patients with mild manifestations of essential tremor do not need drug treatment. To eliminate tremors of one or another part of the body, they just need to give up caffeine-containing drinks (coffee, tea), eliminate alcohol and smoking, increase physical activity, time spent in the fresh air and avoid stress.
In case of severe essential tremor, drug treatment is prescribed. Timely initiation of therapy improves its effectiveness.
Dental reasons
When treating teeth and performing some types of cosmetic procedures, local anesthesia is used, which reduces the sensitivity of tissues. During the period of action of the drug, lips, cheeks, and other areas of the face become numb. After completion of the therapeutic manipulations, sensitivity is restored on its own.
Numbness of the lips and tongue is accompanied by inflammatory processes in the oral cavity. This happens with gingivitis, periodontal disease, and purulent lesions. Soft tissues are involved in the pathological process, which causes swelling and impaired receptor sensitivity.
Which doctor should I contact?
The causes of numbness in any area of the head (face, back of the head, right or left side) will be different factors and situations. There is no need to make a diagnosis yourself. To identify the exact causes, you need to contact medical specialists.
The very first doctor to confirm or rule out pathology of the nervous system should be a neurologist. The feeling of numbness is associated with loss of sensitivity, which means that somewhere the passage of electrical impulses along the nerve fiber is disrupted.
A common cause is osteochondrosis of the cervical spine; due to chronic changes in the intervertebral discs, the nerve roots are pinched by neighboring vertebrae. A more serious cause may be a stroke.
Symptoms are sometimes associated with compression of nerves and blood vessels. There is a decrease, sometimes significantly, in the access of nutrients and oxygen to tissues.
The lack of these important elements in a certain area of the muscles and skin creates conditions under which the sensitivity of nerve receptors is disrupted, and a feeling of numbness occurs. It may appear against the background of vascular sclerosis, arterial plaques, or blockage by a detached blood clot.
The obligatory specialist to visit will be a doctor who deals with vascular pathology - a vascular surgeon.
If a person has been suffering from diabetes for a long time, and part of his head has become numb, the issue should be resolved together with his treating endocrinologist. Regularly elevated blood sugar levels lead to nerve damage, and this can provoke the development of paresthesia.
If trauma is the reason that your head is numb, the first doctor you need to see should be an orthopedic traumatologist. It determines what is damaged in the musculoskeletal system, the extent of the damage, and whether rehabilitation is needed. If necessary, the traumatologist can prescribe a consultation or treatment with a surgeon.
Incorrect bite can be one of the reasons for facial numbness. Deviations from the norm in the bite cause additional stress on the jaw muscles and chewing joints. The facial nerve is compressed and paresthesia develops.
To correct the bite and get rid of these unpleasant sensations, treatment by an orthodontist is required.
In rare cases, facial paresthesia occurs after tooth extraction when the nerve has been damaged. If this happens, you need to return to the dental surgeon who removed the tooth so that he can prescribe treatment.
If other specialists have not confirmed the presence of pathology in their area, then perhaps the appearance of a feeling of numbness is associated with an infection that has entered the body and affects the nervous tissue. Here you will need to consult an infectious disease specialist.
With a viral or bacterial infection of the middle ear, sinuses, throat, or respiratory tract, inflammation of the trigeminal nerve may occur. Or with meningitis.
There is another disease - Lyme disease (borreliosis), which occurs when a tick bites. The cause will also be any infection, the complications of which may lead to numbness in the head.
Sometimes paresthesia occurs with autoimmune diseases (systemic lupus erythematosus, multiple sclerosis). The immune system, for unknown reasons, begins to attack tissues, mistaking them for foreign. Here a visit to an immunologist will be necessary.
If a person has been exposed to chemicals that have led to intoxication of the body, and he has a feeling of numbness, emergency medical care is needed to cleanse the blood of toxins and the help of a toxicologist.
It happens that the effect of toxins on the body lasts for a long time (harmful production or alcoholism). They slowly but surely destroy nervous tissue, which leads to paresthesia.
Sometimes the head can go numb as a result of psychological pressures that are associated with stress. A person does not even notice how he takes a certain position, in which the muscles are overstrained, and they compress the nerves.
Here you will need a consultation with a psychiatrist who will prescribe sedatives, or the help of a good psychologist.
Once again, we list the doctors whose help may be needed to determine the causes of numbness of the scalp:
- Neurologist;
- Vascular surgeon;
- Endocrinologist;
- Traumatologist;
- Dentist;
- Infectious disease physician;
- Immunologist;
- Toxicologist;
- Psychiatrist or psychologist.
It happens that paresthesia occurs due to compression of the spinal cord or brain by various tumor processes. This is done by an oncologist.
Why do lips swell?
If your lip is swollen, the reasons for this phenomenon may be:
- bruises;
- mucosal injuries;
- herpes or other infections;
- violation of the rules for performing dental procedures;
- inflammatory processes;
- sleeping in the “wrong” position;
- allergic reactions.
When the lip swells, it can be caused by cancer, thermal injuries in the form of frostbite or burns, the body's reaction to anesthesia, to food irritants (cirus fruits, mint, pepper). The mouth may become swollen if the day before cosmetic procedures were carried out related to correcting its shape, scrubbing, applying permanent makeup, piercing, or piercing.
Swelling in the morning may be preceded by a large amount of liquid drunk the night before or the development of allergic reactions. Swelling is often found on the face in men who abuse alcohol. In this case, they last for 2 hours or more during the day.
In some cases, lips become swollen due to the habit of biting them. This can lead to infection with subsequent development of swelling, damage to the mucosa and the need to treat the person with antibiotics.
The following situation is common: the lip is swollen from herpes. This virus is present in the body of more than 80% of the world's population. During a cold or pregnancy, herpes is activated in the form of sores in various parts of the body.
Tips for treating and preventing lip swelling
For whatever reason, lips and areas of facial skin are swollen, you should not start treatment without consulting a doctor and proper diagnosis. Usually, inflammation of the upper or lower lip goes away quickly, but in order not to disrupt this process and not to aggravate the condition, you must follow a number of rules:
- open wounds cannot be treated with ointments and compresses;
- for closed injuries, warming compresses and ointments should also not be used;
- in the first hours after injury, you should not eat food;
- during the period of healing of wounds and treatment of edema, you should eat exclusively warm food, you should not eat salty and spicy foods;
- If your lip is inflamed, you should not use cosmetics.
The healing of the piercing must be taken responsibly; you must strictly follow the specialist’s instructions and monitor your condition. It is better to be scrupulous when choosing a salon and a specialist: the procedure must be carried out with skillful hands and in sterile conditions.
When an infection enters the piercing hole, the lips become swollen, painful, and itchy. If such symptoms develop, you should consult a doctor, especially if the temperature rises and swelling appears in the area of the lymph nodes.
Cracks and jams appear as a result of chapped lips, against the background of a cold, as well as due to endocrine disorders and a lack of certain vitamins in the body (which only a doctor can determine based on tests). They are treated with antiseptics and anti-inflammatory drugs.
The development of vitamin deficiency and predisposition to colds and viral infections will be prevented by proper nutrition and hardening. The body's ability to restore damaged tissues also directly depends on the immune system. In winter, sensitive lip skin should be treated with nourishing balms and masks.
If your lips swell inside for no apparent reason, you should immediately consult a doctor. Swelling may indicate the presence of hidden internal pathologies, which only a doctor can identify and cure.
