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Neurology  (Expert Forum)
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trigeminal neuralgia?
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trigeminal neuralgia?

by leila, Mar 05, 2003 12:00AM
I have been suffering facial and head pain for some time now.  I had prickling in my eyes, stabbing sensations and drawing pulling pain in my forehead, face, cheek and upper jaw.  I had almost constant pain in the teeth in my upper jaw.  All this happens on the left side of my head/face.  My eye gets irritated and draughts, heat, light and pressure sets the pain off.  Eventually, after being given artificial tears, which did nothing to help at all, I was diagnosed with trigeminal neuralgia.  I now take amitriptyline 10mg in the evening and this helps enormously.  I am now getting the symptoms recurring and breaking through.  I also suffer buzzing and pressure sensations in and around my left ear.  Is this the effect of the amitriptyline?  I get odd numb sensations in my lips, which come and go.  I am concerned that the pain is coming back, that I am not convinced that it is 'just' trigeminal neuralgia, and that I am so tired all the time (I have CFS too).  I am also taking sertraline for depression and have had irritable bowel syndrome with pain radiating down my right leg from the abdomen.  Are there any other drugs that might solve some of these problems?  Should I be worried about the neuralgia and what is causing it?

Thanks,

J

by CCF-Neuro-M.D.-JT, Mar 05, 2003 12:00AM
The symptoms do sound like trigeminal neuralgia, but a formal neurological examination may help in confirming or refuting the diagnosis depending on what they find.  Unfortunately, there's no lab test that says you absolutely do or do not have it.  The diagnosis is based on the clinical history and exam.  An MRI of the brain may also be considered to see if there is an underlying cause for the pain.  SOmetimes an artery can push on the nerve, irritating it to cause symptoms of pain and hypersensitivity.  Neurosurgery has helped some patients with this type of problem.



Drugs that we have used for this include anti-seizure medications such as tegretol, trileptal, and dilantin just to name a few.  Elavil has helped many of my patients, and you could consider combination therapy with one of the other meds mentioned. GOod luck.
Member Comments (3)

by pooh56, Mar 07, 2003 12:00AM
I've been diagnosed with atypical trigeminal neuralgia and I'm currently taking 3,200 mgs of neurontin.  This puts a "blanket" over the atypical pain but,doesn't help the trigeminal pain.  I was on trileptal, but it didn't help. My neurolgist said that finding the right meds is the trick.  I do have alot of side effects with the neurontin and I had to go on short term disability and just recently submitted my paperwork for social security disability.  Seems like I have more bad days than good days.  I had an MRI (not a thin cut) and, of course, it didn't show anything.  My neurolgist wants me to keep active....I go the the gym,seeing a chiropractor and a board certified massage therapist.  I've tried...hot/cold packs,heating pad,tens unit,hot pepper creams...all to no avail!!!Is there a light at the end of the tunnel?  Thank you, in advance, for any and all help....

by choya, Apr 14, 2003 12:00AM
I was diagnosed with atypical trigeminal neuralgia due to constant aching in my upper teeth and occasional schock like pain in my jaw.  Had some recent blood work and they found an autoimmune disorder, possible sjorgen's syndrome.  Have tried Elavil which did not help and trileptal, which I had an allergic reaction.  I am now trying Topomax.  I have always been generally healthy and this is incredibly depressing.  The hardest part is that I seem to go from doctor to doctor and noone really can pin down a diagnosis
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