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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: atypical facial pain, help neededForum: Neurology Forum
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My wife has suffered facial pain for 23 years, which has worsned over the past 5 years to become debilitating. Her symptoms are very like TN but there is no remission except when she lies down. There is intense pain in her upper jaw which started after repeated work and teeth extractions to relieve lesser pain. The situation is becoming critical because of the amount of medication she takes. The main agent the keep her on her feet is parstelin, she also takes mixtures of paracetamol and codine, anti-depressants, (constant pain is depressing,) sleeping tablets, and the situation is becoming dangerous according to her GP. When she wakes in the morning she has a severe headache and has to get up, after a few minutes the pain in her jaw begins to build and she has to sit and take her medication until the level allows her to function. The headache usually goes away and leaves only the intense throbbing pain in her upper jaw. Alcohol can give her relief sometimes after she has used up her tablet quota, (is this worst than pills?). She is not allowed to drive because of the medication and is virtually housebound as she cannot manage to go out alone because of loss of balance. Medical resources in Norway are expensive and limited. We have tried, many pain killers including tegratol, acupuncture, healers, physiotherapy, kiropractors, neurologists, ENT specialists, dental specialists, and most recently EMF in the neck area. Nothing shows on CTs or X-rays, (only extra activity using radio active isotopes) there appears to be no infection. My wife urgently needs a better diagnosis and some alternative treatment that will work. I would take anywhere, but my wife has lost hope and has a problem to face more treatment followed by more disappointment. She can only be persuaded to travel locally, anything else would have to look certain. I am sorry if this is too long but it is only a summary of the treatments and events that led us to this situation. Any help or suggestions would be gratefully received. = I am sorry about the delay in responding to your post. Your wife is indeed unfortunate, and I'm not sure exactly what to recommend. Clearly, she has been evaluated sufficiently to rule out causes of pain with different treatment. Pain management for atypical facial pain is very difficult. I don't know if pain management specialists are common in Norway. That's the only thing I can think of right now. You've mentioned several medications I have used for some of my patients, so you need more expertise than a neurologist is likely to provide. I hope this helps, wish I could offer something concrete. CCF MD mdf.
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