Cranial Nerve Damage

[judycarol1]

My husband, 73 years old, has suffered for fourteen months with extreme left side facial pain and numbness.  It started out with his left eyelid drooping until it was fully closed.  He has see four specialist and no one seems to know what is causing the problem.  He had a biopsy in May of the tissue behind the left eye but it was incomplete due to crushed tissue.  He is scheduled for a second biopsy.  He has had negative labs on all sexually transmitted diseases, no cancer cells in the blood, MRIs show nothing.  Tolosa Hunt Syndrome was ruled out.  He has cranial nerve damage to III, V1 V2 V3, VI.  His lips are numb, tongue left side, and now is having problems swallowing.
Before all the above, he had a skin cancer removed from his nose, surgeon went very deep into the
mid top of nose, and he pulled skin over nose rather than skin graft.  Do you think it is possible that all symptoms arose from surgery.  Most important....he had an active cold sore on his bottom left lip.  Could a herpes virus do all this damage even to the eye.  HELP

[judycarol1]

Thanks for the quick response......Yes, HSV did show in bloodwork, so Neurologist ordered PICC Line and intravenous Acyclovir.  Husband was given three three week infusions, 3 a day for three weeks.......short break.......then Acyclovir again, plus last infusion was with Sedmedrol(maybe mispelled).  He became slightly dehydrated and his kidneys were becoming stressed so he was hospitalized.  Current (2nd) Neurologist thinks my husband has an orbital lymphoma.  Lumbar Puncture shows no invasive cancer cells, but showed monocyctes.  By the way, he has had four MRIs in the last year.  He has an upcoming orbital biopsy (2nd) soon at UNC Chapel Hill,NC.  Excellent surgeon and I am praying it will show something.  Are you a doctor?  

[JainMD]

Hi Judy,
How are you feeling?
Yes the deep surgery can damage the nerve in surrounding area which is why he is having numbness along V1, V2, and V3 area.
His problems of swallowing are linked to IXth cranial nerve.
Herpes can cause problems with swallowing and facial numbness if there are other associated symptoms to prove it.
I think you should be consulting another neurologist at earliest and discuss regarding further management.
You should also discuss his MRI's with another neuro-radiologist for re-evaluation and if any space occupying lesion exists.
Keep me informed if you have any queries.
Bye.