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CHRONIC FACE PAIN ON ONE SIDE
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CHRONIC FACE PAIN ON ONE SIDE


  Help! I have had chronic pain for nine months.  I started one day after exercising- I just had this extreme pain come over my face.  It is predominantly on my left side of my face from my jaw to my temple.  My vision is also affected it seems as though I have a hard time focusing.
  I have had two root canals on the back teeth on the upper left side of my mouth and recently I had those two teeth pulled. But still no relief. Also, they have ruled out it being TMJ or any problem with my eyes themselves.  I have had them check my sinsuses by doing a cat-scan and that came back clear.  They did a bone-scan and that showed a dark spot in the upper area of my left jaw.  The endodontist went into my jaw and noticed a lesion had developed and that the bone was eaten completely away in one area.  
  I just had those teeth removed and am still in pain.  I have been taking anaprox, vicodin and amitril for the pain.
  I get a relief about every six weeks when I feel this warm rush come from my forehead down through my nose and throughout my whole body and the pain is gone.  My dr just referred me to a neurologist and he wants to do an MRI of my brain and spinal cord.  Do you have any idea about this?  Thanks.
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The symptoms you describe are in the distribution of the trigeminal nerve, which supplies sensation to
one side of the face, anything which irritates the nerve anywhere from its origin in the brainstem to the periphery will cause pain in the sensory distribution of the nerve.
It sounds like the more peripheral causes have been excluded, those being problems in the jaw, teeth, sinuses or TMJ which are the more common causes of pain in this area.
Now that the more peripheral causes have been excluded it is time to move the search for a cause further inward to visualise the anatomy closer to the brainstem ,including the brain itself. The test of choice to visualize this area is the MRI scan , so I think your physician is on the right track.
As regards therapy some further options would be the anticonvulsant drugs tegretol and neurontin which have been very effective in these types of pain syndromes, the key priority at this stage is to find the root cause of the problem and I feel the MRI is the way to proceed with this.





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