Facial numbness in the ophthalmology clinic. A portentous sign

Eye (Lond). 2020 Apr;34(4):663-668. doi: 10.1038/s41433-019-0565-1. Epub 2019 Aug 30.

Abstract

Aim: To report a case series of 14 patients presenting with facial numbness primarily to the ophthalmology clinic.

Methods: All patients presenting with facial numbness to the ophthalmology clinic at the University of California, Los Angeles, were reviewed for study entry between 1993 and the present. Patients with a history of trauma or surgery were excluded.

Results: Fourteen patients (eight females and six males) presented to the ophthalmology clinic with numbness. Nine patients (64%) presented primarily with numbness. This symptom was associated with mortality (57%) and significant morbidity. The most common cause was neoplastic pathology (n = 10, 71%), with perineural spread from squamous cell carcinoma being the most common (five cases, 36%). The remaining cases were related to infection (n = 4, 29%).

Conclusions: Most of the patients presenting to our service with numbness eventually died due to their condition. Given the poor prognosis of the patients in our case series, numbness of the face may be a portentous sign and therefore warrants a thorough examination with close follow up.

MeSH terms

  • Carcinoma, Squamous Cell*
  • Face
  • Female
  • Humans
  • Hypesthesia / diagnosis
  • Hypesthesia / etiology
  • Male
  • Ophthalmology*