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nose relentless vibrating/pulsatile/throbbing pain with headache for 1....
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nose relentless vibrating/pulsatile/throbbing pain with headache for 1.5 yr

Hi, have suffering this totally distressful pain condition for 1.5 yr now, it is constant. When it first started it came out of the blue, when i felt that wearing glasses pressing on my nose bridge created a headache immediately. Now I'm wearing contacts, but the pain is constantly centered on my nose. I can feel both sides of my nose constantly vibrating/throbbing corresponding to my heartbeat (main syptom (symptom)), accompanied by pain at the centre of my forehead above the bridge of my nose, frequent eye pain (behind the eyes), sometimes sides of head and top of head feel sudden pain as well. This is also accompanied by pressure in my head.

Nerve meds don't work (I have taken neurontin, epilim, amitrypline, lyrica, tegretol), and CT and MRI scans are negative. External stimuli now do not change my pain at all. Several ENTs told me they can't find anything physically wrong except a deviated septum and a concha bullosa (but no obvious sinusitis) so did not advise surgery. The nerves at both sides of my nose relentlessly vibrate and pulsate and I feel that they are responsible for the pain felt in my sinus area. Any relation to Sluder's neuralgia or the anterior ethmoid syndrme?  

My pain started on the right side of my nose, but over time became bilateral. An MRI scan revealed that my right trigeminal nerve is running close to some artery. But the neurosurgeon I consulted said that he wouldn't want to operate on me through MVD because my pain is bilateral and my pain syndrome is not that of trigeminal neuralgia. My pain specialist suggested a sphenopalatine ganglion block (a surgical invasive procedure) but my mum wouldn't hear of it.

I feel a little less pressure when I tilt my head backwards, and can feel the nerves in my nose vibrating more intensely when I massage the back of my head.  

I have suffered a lot alot through the 1.5 yr, but the pain remained the same. Pls help. Thanks...

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Dear Bullyboo,
Many thanks for posting the question and allowing me to answer it.
If all the examinations are normal, then "Anterior Ethmoid Nerve Syndrome" is the only diagnosis left.
But the sad part is that, it's the least common diagnosis.Maybe due to this reason it got omitted from the list of common diagnosis.
The syndrome is related to the "Naso-Cillary Nerve which is later known as Anterior Ethmoid Nerve.The common symptoms experienced are dull ache between the eyes,rhinitis,eye ball pain,etc.
I would suggest you to change your doctor and get second or even third opinion.If any doctor is able to diagnose the same, then it would be good as the last treatment for this condition is surgery and not all ENT's are knowing about the same.
Feel free to discuss more in this context.
Regards
3 Comments
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Hi Doctor,

could you give some info regarding sphenopalatine ganglion block (referring to the surgical and invasive type) and whether you think it could help me with the above pain condition? Can't seem to get much info about it on the net. Need to know whether it can help me, how long it lasts, and possible side effects. If you know could you please answer. Thanks vry much.

Rgds,
Bullyboo

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