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Recurrent tingling sensation on neck bears investigation

By Keith Roach, M.D. on

DEAR DR. ROACH: I am a 58-year-old male who takes losartan for high blood pressure and Prilosec for GERD. A couple of times a day, I get a tingling on the left side of my neck from roughly my left ear to my chin. Sometimes it occurs when I'm chewing, but sometimes not. It never lasts more than a few minutes. It can be rather intense, but doesn't hurt. Do you have any idea what's going on? I haven't told my doctor just because I don't want to sound like a baby. -- M.P.

ANSWER: Tingling sensations usually are due to nerve problems, such as compression. There is a nerve that runs from the ear to the chin, called the mandibular nerve; it's also called the V3 division of the trigeminal nerve. ("V" because it's the fifth nerve that comes off the brainstem; "3" because it's the third part of the trigeminal nerve. So it is the third division of the fifth cranial nerve.)

There are several potential problems with the nerve that could produce tingling: Pressure on the nerve from the jaw might be causing it. Some people get tingling before an episode of shingles. Dental problems sometimes can generate a sensation along the whole range of the nerve. Trigeminal neuralgia causes recurrent episodes of intense electrical sensations; some people get other sensations before the pain starts.

Temporal arteritis, a potentially dangerous inflammation of the blood vessel, can cause jaw pain when chewing; however, there are other symptoms that are common, which you didn't mention.

I guarantee your doctor will not think you are a baby. When I have a patient who seldom sees me for acute issues and comes in with a new problem, I take it more seriously. You should get it evaluated.

DEAR DR. ROACH: I am 71 and never was hairy. But several years ago, every hair on my body, it seems, decided to go on a nonstop growth spurt! My wife says, when she trims my back, that gorillas would be envious of me.

 

I asked my doctor about it, and she said: "Don't worry, it's normal in some men at your age." Why the sudden growth, what purpose would it serve, and why in just some men? -- J.K.

ANSWER: Body hair in men generally is responsive to testosterone. Although testosterone levels tend to decrease over the adult lifespan, the hairs in some men become more sensitive to the growth effects of testosterone. That's the most likely explanation. It's also possible that your testosterone is abnormally high: Perhaps your doctor checked that, since an elevation is very rarely caused by a tumor.

I am always cautious about assigning purpose to physiological changes. Many people feel that there is likely some evolutionary advantage to the physiological changes we see, but I don't think that's always the case. Sometimes the reasons are very complex, defying easy explanation. In any case, I have no explanation for why hair cells become more sensitive to testosterone, nor why testosterone levels decrease in men as they get older. Many physiological processes do better with testosterone levels in the range of young men: That's a major reason for supplementing testosterone in older men with symptoms.

Interestingly, scalp hair has a different response to testosterone from body hair: Scalp hair is more likely to fall out with testosterone.

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