I have little numbness on my leftside of face - #9735

Consult your doctor to determine the proper treatment plan for vitamin B12 supplementation and to rule out any other underlying conditions.

This could be due to vitamin b12 deficiency Start tab neurobion forte once daily for 15 days In case you continue to have numbness get mri brain with cervical spine done

**Patient Name**: Vaibhav Kishor **Age**: 24 years **Date**: 12-04-2025 **Consultation Type**: General Medicine / Neurology Evaluation **Chronic Illnesses**: None **Presenting Complaints**: - Numbness on the left side of the face (past 10 days) - Mild facial swelling - Persistent dizziness throughout the day - Recent B12 levels found to be mildly low - Mentzer Index: 15 **Clinical Impression**: The patient is presenting with **unilateral facial numbness and dizziness**, which could be of neurological origin. Mild **Vitamin B12 deficiency** may contribute to neurological symptoms like paresthesia and dizziness. Mentzer Index of 15 is borderline and may suggest a tendency toward anemia of chronic disease or borderline microcytic anemia but requires further evaluation. Unilateral facial symptoms may suggest involvement of **cranial nerves**, possibly **trigeminal nerve (CN V)** or early signs of **Bell’s palsy**mild facial neuropathy**, or other causes including **viral inflammation, sinus involvement, or vascular insufficiency**. Dizziness could also be due to **inner ear disturbances**, **cervical spondylosis**, or **systemic causes like anemia or B12 deficiency**. **Plan of Management**: Important 1. **Investigations Advised**: - MRI Brain (plain) – to rule out any central neurological cause - Complete Blood Count (CBC) - Serum Vitamin B12, Folic Acid, and Ferritin - Thyroid Profile (TSH, T3, T4) - Blood pressure monitoring (postural) - Serum electrolytes and blood sugar levels - ENT consultation if dizziness persists 2. **Medications**: **Tab. Methylcobalamin 1500 mcg OD** (after meals) for 8–12 weeks **Tab. Folic Acid 5 mg OD** for 4 weeks **Tab. Betahistine 8–16 mg BD** if dizziness persists (to be taken only after physician evaluation) **Tab. Paracetamol 500 mg SOS** for facial discomfort (if present) 3. **Diet & Lifestyle**: - Include B12-rich foods in the diet: dairy, eggs, fish, fortified cereals - Avoid alcohol and smoking (if applicable) - Adequate hydration - Balanced meals rich in iron, folate, and B-complex vitamins - Gentle neck stretching or yoga (if no neurological contraindication) Sleep hygiene and stress management 4. **Referral**: Neurology– for evaluation of facial numbness and dizziness **ENT** if inner ear pathology suspected for dizziness **Nutritionist** for B12 and anemia management through diet Provisional Diagnosis Peripheral Neuropathy due to B12 Deficiency **Rule Out Cranial Neuropathy / Bell’s Palsy **Borderline Anemia – Investigate Cause Further Follow-Up After MRI and lab reports or earlier if symptoms worsen Dr Shayeque Reza MD 9800280276

Hello, With regards to your concern Cause of numbness can be due to facial nerve involvement B12 deficiency can give symptoms all over the body and skin. Kindly use tablet Gabapentin 150 mg at night