J Am Osteopath Assoc ; 7: Whiplash injury is often caused by rear-end motor vehicle collisions. Symptoms such as neck pain and stiffness or arm pain or numbness are common with whiplash injury. The author reports a case of right facial numbness and
Neck nerve facial numbness cheek pain after a whiplash injury. Osteopathic manipulative treatment techniques applied at the level of the cervical spine, suboccipital region, and cranial region alleviated the patient's facial symptoms by treating the right-sided strain of Neck nerve facial numbness trigeminal nerve.
The strain on the trigeminal nerve likely occurred at the upper cervical spine, at the nerve's cauda, and at the brainstem, the nerve's point of origin. The temporal portion of the cranium played a major role in the strain on the maxillary.
Report of Case Comment Conclusion References. Dr Genese has master's degree in medical science. You will receive an email whenever this article is corrected, updated, or cited in the literature. You can manage this and all other alerts in My Account.
A whiplash injury refers to the sudden flexion and extension of the neck from a traumatic event and is commonly associated with rear-end and head-on motor vehicle collisions. Whiplash-associated disorder refers to symptoms that develop after whiplash injury such as headache at the base of the skull, neck pain, neck spasm, and stiffness in the neck. A prospective study of 34 patients by Sterner et al 3 reported trigeminal sensory impairment after whiplash trauma and concluded that the impairment was caused by dysfunction of the central nervous system or inhibitory mechanisms; no statistically significant relationship connected whiplash trauma to musculoskeletal symptoms.
Finally, Jacob et al 5 reported cases of rare headache syndromes classified as trigeminal autonomic cephalagias, which Neck nerve facial numbness short-lasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing and paroxysmal orbitofrontal-temporal pains.
In the present report, I describe a case of whiplash injury with an unusual manifestation of right facial numbness and right cheek pain. This case Neck nerve facial numbness the benefits of osteopathic manipulative treatment OMT. A woman presented to the walk-in clinic with a complaint of Neck nerve facial numbness facial numbness and right cheek pain 24 hours after a motor vehicle collision. She was riding in the front passenger seat when the accident occurred.
She described her facial pain as a constant ache, rating the level of pain at 4 out of The onset of pain occurred and was noted by the patient shortly after the incident. She had taken no means to relieve that pain and assumed the pain would resolve on its own.
The patient recounted that the car in which she was a passenger was slowing down when it was struck from behind by a car travelling at a high speed. This caused the car she was in to strike the truck in front of her. She was restrained by the seat belt but the air bags did not deploy. She had no recollection of hitting her head but remembered her neck and head taking on a whipping movement. She did not consider her injury serious enough to merit immediate medical attention.
The patient presented a day later because of the persistent request of her friend who was driving the
Neck nerve facial numbness. In addition to the right facial numbness and right cheek pain, she reported clear watery drainage from the right ear, discomfort in the right shoulder and right side of the neck where her seat had contact, and vertigo.
The patient denied chest pain, shortness of breath, fevers, or chills. She attributed her vertigo, which had been present on and off for years, to chronic seasonal allergies. Her past medical history was notable for seasonal allergies causing congestion in her right ear and some right cheek swelling; she had been seeing an allergist for both conditions.
The patient reported that she had never been in a car accident before the previous day but that she had bone spurs in both shoulders. A motor examination revealed her cranial Neck nerve facial numbness to be intact. She was receptive to light touch for all cranial nerves except for the trigeminal nerve on the right. Her sinuses were not tender to palpation. Her right tympanic membrane was opacified and appeared mildly injected. Results of her heart and lung examinations were normal.
Osteopathic structural examination revealed left greater than right paraspinal muscle spasm from the level of the T10 to L4 vertebrae, Neck nerve facial numbness tender point in the left paraspinal at the level of the L3 vertebra, right paraspinal cervical spasm from the level of the C2 to C5 vertebrae, and an extended occipitoatlantal OA joint.
"Neck nerve facial numbness"
She demonstrated no point tenderness along the spine and no apparent stiffness. I began by treating the left thoracolumbar paraspinal spasm with myofascial release and inhibitory pressure technique. As I performed the inhibitory pressure technique, I instructed the patient to breathe deeply as I gently applied pressure to the painful spasm in her lumbar region. I then switched to the counterstrain technique because of her increasing amount of pain. With this technique, I found the most painful point in this area of lumbar spasm: After applying OMT to the somatic dysfunction in the thoracic and lumbar regions, I applied myofascial to the spasm along the cervical spine.
As the spasm resolved, I used Neck nerve facial numbness decompression to treat the extended occipitoatlantal joint.
I returned to the cervical spine to treat the remaining spasms with myofascial release technique. The patient reported that her numbness had resolved but that her right cheek still hurt. I then checked her cranium for restrictions and noted that the right temporal section was locked in internal rotation. I continued to monitor the temporal portion of the cranium via contact with the ear lobes until I sensed symmetrical internal and external rotation of the cranium. The patient stated that the pain in her cheek had resolved.
The patient remained symptom free at 4-month and 6-month follow-up. Neck nerve facial numbness treating a patient who has experienced an acute traumatic event such as a whiplash injury, techniques that could aggravate existing muscle spasms eg, high-velocity, low-amplitude should be avoided. The OMT techniques used for the patient described in the current report were myofascial release, inhibition, counterstrain, and cranial OMT.
The inhibition technique in the lumbar region induced too much pain for the patient to tolerate. Any OMT techniques applied to the thoracic spine and suboccipital area should precede treatment of the cervical spine in whiplash injuries. Both treatment regimens were 2 weeks long.
After the current patient's thoracolumbar area was treated, decompression of the extended occipitoatlantal region relieved the numbness Neck nerve facial numbness the right side of her face but did not mitigate her right cheek pain.
The right facial involvement implicates the fifth cranial nerve, or the trigeminal nerve. Pathologic conditions that may affect the trigeminal nerve are neoplasm, vascular compression, Neck nerve facial numbness or bleeding, multiple sclerosis, osteitis, viral rhomboencephalitis, syringobulbia, abscess, and sinusitis. I next evaluated the cranium, specifically the temporal portion, because of the patient's long-standing history of allergies affecting her right inner ear and because of the close relationship the trigeminal nerve has with this area.
The trigeminal Neck nerve facial numbness provides sensation to the face and a
Neck nerve facial numbness part of the scalp and has 3 divisions: The nuclei reside in ventral pons of the brainstem. A portion of nerve fibers descend from the brainstem and reach the upper cervical portion of the spine, which involves mostly pain and thermal sensation.
Sensory axons from the pons travel anteriorly along the petrous ridge of the temporal bone to the trigeminal Neck nerve facial numbness, which is found in the trigeminal cave ie, the Meckel space. This ganglion then sends the 3 branches of the trigeminal nerve through the superior orbital fissure ophthalmic branchforamen rotundum maxillary branchand foramen ovale mandibular branch of the sphenoid bone.
The right cheek numbness that the patient reported likely originated in the maxillary nerve, which is wholly sensory and exits from the foramen rotundum inferolateral to the cavernous sinus. The nerve then enters the pterygopalatine sphenopalatine fossa, its main trunk inclining laterally on the posterior surface of the palatine bone at the orbital process and on the upper "Neck nerve facial numbness" of the posterior surface of the maxilla.
The maxillary nerve continues through the infraorbital fissure of the maxilla and emerges as the infraorbital nerve, which innervates the middle third of the face and upper teeth.
Restriction or pathologic conditions anywhere along Neck nerve facial numbness trigeminal nerve affects facial sensation. Patients with upper cervical disk herniation will sometimes present with trigeminal sensory neuropathy.
The resolution of the patient's cheek pain after treatment indicates that the temporal area of the cranium may have contributed to the irritation of Neck nerve facial numbness V2 branch of the trigeminal nerve by indirectly affecting the sphenoid and the maxilla where V2 re-emerges. The strain may have "Neck nerve facial numbness" in the cranium anywhere along the path of the maxillary nerve.
The patient's symptoms are unique to whiplash-associated disorder. The preexisting pathology, coupled with the patient's allergies, limited the severity of the whiplash injury.
The car accident may have been the final factor that caused her unusual presentation. The occipitoatlantal and cervical areas proved to be the chief factors in the patient's facial numbness. The right temporal bone also played a major role in the patient's facial pain. Knowledge of anatomy, OMT techniques, and osteopathic principles and practice is important in successful management of musculoskeletal injury, especially in novel cases. Osteopathic maniulative treatment offers relief for patients by addressing the cause instead of masking the symptoms, as seen in the present case.
Isaac Z, Anderson BC. Evaluation of the patient with Neck nerve facial numbness pain and cervical spine disorders. Updated January 22 Accessed June 17, Frequent jaw-face pain in chronic whiplash-associated disorders. Prospective study of trigeminal sensibility after whiplash trauma.
Trigeminal sensory impairment after soft-tissue injury of the cervical spine: Post-traumatic short-lasting unilateral headache with cranial autonomic symptoms SUNA. Chila AG, executive ed.
Foundations of Osteopathic Medicine. Effects of myofascial technique in patients with subacute whiplash associated disorders: Eur J Phys Rehabil Med. Woolfal P, "Neck nerve facial numbness" A.
Skin cancer of the head and neck with perineural invasion. Numbness is most often caused by damage, irritation or compression nerves. A single nerve branch, or several nerves, may be affected, as with a slipped disc. Symptoms such as neck pain and stiffness or arm pain or numbness are common with facial symptoms by treating the right-sided strain of the trigeminal nerve.
MORE: Bbw scene with facial