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Neurology (Expert Forum)
Trigeminal neuralgia?
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Trigeminal neuralgia?
by Pixiangelj, Sep 11, 2006 12:00AM
Hi- I posted in here a while back about a removal of a brain tumor (pilocytic astrocytoma) in the mentencephalon area, September 2004. Before the surgery, I was unable to go in the car or watch tv, my left eye hurt, and I would get sick nauseous, dizzy.
After the surgery, I woke up and I had no feeling on the left side of my face.Directly after the surgery, I was kinda looking past everyone, gazing, it was hard to move my eye. When I did start moving my eyes again, my left eye (numb side) would just throb, so I patched it for a while. Within the last year,I am getting these sharp shooting pains through the left side of my face (can be triggered, wind especially); they are becoming more frequent. I saw a GP and he told me it sounds like trigeminal neuralgia, but I should see a neurologist/or my surgeon.
Sometimes I just get these crippling pains in my left eye (like before surgery, that make me sick) that last a day or so. How is it possible to feel pain and have such a loss of sensation, pressure, and temperature? Even acidic foods just burn the back of my tongue to the point my eyes tear/lose appetite, or just can't eat anymore.Would Anesthesia Dolorosa apply here? This would be considered secondary/atypical/idiopathic? What are the chances of it becoming worse? Is the nerve severed? I recently had my wisdon teeth out (all 4 bone impacted) and the right side bruised and swelled,normal,and the left side remained the same. I know it’s a hard over the internet, but is this something I should talk to a Dr. about? There's a lot here!! Thanks for any help and inight~
After the surgery, I woke up and I had no feeling on the left side of my face.Directly after the surgery, I was kinda looking past everyone, gazing, it was hard to move my eye. When I did start moving my eyes again, my left eye (numb side) would just throb, so I patched it for a while. Within the last year,I am getting these sharp shooting pains through the left side of my face (can be triggered, wind especially); they are becoming more frequent. I saw a GP and he told me it sounds like trigeminal neuralgia, but I should see a neurologist/or my surgeon.
Sometimes I just get these crippling pains in my left eye (like before surgery, that make me sick) that last a day or so. How is it possible to feel pain and have such a loss of sensation, pressure, and temperature? Even acidic foods just burn the back of my tongue to the point my eyes tear/lose appetite, or just can't eat anymore.Would Anesthesia Dolorosa apply here? This would be considered secondary/atypical/idiopathic? What are the chances of it becoming worse? Is the nerve severed? I recently had my wisdon teeth out (all 4 bone impacted) and the right side bruised and swelled,normal,and the left side remained the same. I know it’s a hard over the internet, but is this something I should talk to a Dr. about? There's a lot here!! Thanks for any help and inight~
Doctor's Answer
by CCF-Neuro-M.D.-SH, Sep 11, 2006 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
The symptoms you describe are consistent with trigeminal neuralgia type pain and is likely related to an Anesthesia Dolorosa type phenomenon. I do not know precisely were your tumor was, but is sounds like it involved the Pons (middle part of the brainstem) that contains the trigeminal nerve components as well and components that help control eye movements. When this area was damaged by the tumor/ and surgery it results is dysfunction (decreased feeling on left side of face) and abnormal function (constant pain, with sharp stabbing electrical burst of pain)[this is the Anesthesia Dolorosa]. Fortunately, there are some medications and even surgeries that can be helpful for this pain. The sharp electrical pains are helped by medications such as tegretol and/or neurontin. There are also nerve blocks, thalamotomy, cingulotomy, and dorasl root entry zone procedures. I would recommend that you see a neurologist and discuss these options. I would also recommend that you get a repeat MRI of the brain with contrast as pilocytic astrocytomas can recurr (they have diffuse spreading tentacles in the brain that are almost impossible to completely cut out). Often this condition does not get better with time, but can be managed at least to some degree with medications/surgery as mentioned above.
I hope this has been helpful.
The symptoms you describe are consistent with trigeminal neuralgia type pain and is likely related to an Anesthesia Dolorosa type phenomenon. I do not know precisely were your tumor was, but is sounds like it involved the Pons (middle part of the brainstem) that contains the trigeminal nerve components as well and components that help control eye movements. When this area was damaged by the tumor/ and surgery it results is dysfunction (decreased feeling on left side of face) and abnormal function (constant pain, with sharp stabbing electrical burst of pain)[this is the Anesthesia Dolorosa]. Fortunately, there are some medications and even surgeries that can be helpful for this pain. The sharp electrical pains are helped by medications such as tegretol and/or neurontin. There are also nerve blocks, thalamotomy, cingulotomy, and dorasl root entry zone procedures. I would recommend that you see a neurologist and discuss these options. I would also recommend that you get a repeat MRI of the brain with contrast as pilocytic astrocytomas can recurr (they have diffuse spreading tentacles in the brain that are almost impossible to completely cut out). Often this condition does not get better with time, but can be managed at least to some degree with medications/surgery as mentioned above.
I hope this has been helpful.
