Atypical Trigeminal Neuralgia

    
      Re: Re: Re: Re: Atypical Trigeminal Neuralgia
    


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Posted by CCF MD mdf on May 21, 1998 at 12:56:14:

In Reply to: Re: Re: Re: Atypical Trigeminal Neuralgia posted by Barbara Atkinson on May 04, 1998 at 12:55:36:

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  : :Hello out there. I am in PAIN and I don't know what to do! I woke up one morning with ringing in my right ear. I waited a few days to see if this ringing would disappear. No luck. Went to see a Ear Nose and Throat Doc.
  : He found no problem.Went to a neurologist. MRI and Cat scans of Brain, neck,and sinnus cavity were negitive. I have no temperature, no infection.
  : I had a root canal done years ago on a tooth next to eye tooth {first molar}. Just before all this pain in neck and rinning I had a apico on this root canal. I am starting to wonder if this apico caused a problem in my sinus cavity. I was told when I had the apico that I had bone loss and there was a bad infection. The ringing in my ear I can live with but the pain down my neck front and back is driving me nuts. I can't turn my neck very far, there is a crackling noise in the back of my neck, pain in the base of my skull. Can anyone help!
  You may want to do a web search on Myofascial Pain Syndrome.  Something may click.  Best of luck.
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Cases such as this are always tough to figure out. "Typical" trigeminal neuralgia involves a very particular distribution of pain, triggers, duration of episodes, etc. It is understood to be due to irritation of the trigeminal nerve ,the component which carries pain sensation to the brain. Tegretol, Neurontin, and other medications are useful and many are helped. The Janetta procedure, which involves microvascular decompression of the root of the trigeminal nerve, is frequently successful.
That said, as you know, atypical neuralgia is much less straightforward. Certainly the trigeminal system is involved, because that is how the pain message is carried. However, it is less clearly a simple matter of irritation, and many are doubtful of the role of adjacent tiny blood vessels in the production of symptoms. The decompression procedures do not work as well in atypical cases - lower success rate. As you know, surgical procedures carry a nontrivial risk so must be carefully considered.
If you have no answers, and are not confident in your neurologist, you are welcome to call 800 223-2273 ask for ext 4-5559 (neurology appointments) and seek a second opinion consultation.
As you know, this information is provided for your general medical education only. Specific comments regarding your diagnosis, prognosis, and treatment options must come from your physician after appropriate evaluation. CCF MD mdf.