Over a year has passed

[mickislack]

Over a year has passed since I was diagnosed with a concussion.  I am not sure what level of a concussion I had, I know I was unconcious for a few seconds. I do not remember my accident.  After my injury I had terrible headaches and dizzy spells for months and then I was fine.  About a month ago I started having bad headaches again.  I never sufferred from headaches before I hit my head.  My other symptoms after I was injured was that I was getting seizure like symptoms when I fell asleep, those have subsided thank goodness. All tests ran said that I was not suffering from seizures but rather possible sleep paralysis.  I also sufferred a jaw injury that has never healed.  I have been in TMJ therapy, but the splint has not worked miracles for me.  My right face still hurts whenever I yawn or open my mouth very wide. I even have flareups where my whole face hurts for days. I am beginning to feel like the headaches and jaw pain are here to stay.  I know I need to get my jaw questions answered by someone else, but can you tell me how long it takes for posttraumatic headaches to resolve and why people get them?  I did have an MRI and it was negative.

[Ron3]

Hi Micki,

Your trigeminal nerve is probably being impinged where the jaw join flexes, right in front of your ear.  If the pain is not constant, there is a greater chance that this is due to pressure where the nerve comes out of your skull, just in frony of the little flap which covers your ear canal.  Can you press gently on the little hollow just in front of the flap while you open and close your jaw slightly to see if you can cause a beginning of pain on that side of your face?   If you can, you have made your
own diagnosis of Tic Douloureaux.  If the pain is constant but  worsens when you merely touch the skin of your jaw, then RSD seems to be more of a possibility.

If you can cause the pain by moving your jaw from side to side
(as if you were stretching to get a better look at your ear in the mirror) then the jaw is moving too much causing the nerve to be pinched between the two bones.  The fall may have done some damage to supporting ligaments so be careful to limit jaw motion or arthritis can be in your future.

If you wish to continue this volley without maybe boring others,
feel free to email and see if we can cover more possibilites.

Take care.. :)
Ron

[mickislack]

My doctor called it atypical facial pain and put me on tegetrol for the pain in my jaw.  He said its the trigeminal (sp?) nerve possibly.  I took the med last night and it made me very sleepy and there is no way I can take it this morning before work.  I have two kids and I dont want to be getting in an accident.  I think the dosage is high as research on the computer said that the starting dose should be 100 mg. Perhaps I will cut the pill in half when I get to work and see how that happens.  I was reading some stories last night on the computer about people suffering from trigeminal neuralgia and it is quite horrible is some people.  I have had 2 spells in which I cried like a newborn and my husband thought I was crazy, but usually the pain is never ending but not severe.  It hurts to touch my jaw and like I said to use it in any way.  I had xrays like a panorex so if my jaw was in any way fractured I am sure they would have caught it, since it has been over a year.  Thanks again for the info and hopefully this medicine I was put on will help.

[Ron3]

Hi Mikki,

There is another condition that can occur after a trauma to a bone.   It usually occurrs when an arm or a leg receives a blow
which may not even fracture the bone.  It may only cause hairline
fracture or a greenstick type of injury.

If the pain is constant and worsens with use, a possibilty is a hairline fracture that is not healing...  A Dexa Scan (bone scan)
of the injured area can be very helpful and bone strengthening meds like Intravenous pamindronate, Nasal Calcitonin or even
the slower acting Oral Fosamax can be the way to repair the fracture or replace lost bone.  Here is a link, but don't be afraid to do a search on "Reflex Sympathetic Dystrophy"
http://www.drmirkin.com/morehealth/g160.htm

Take care..
Ron

[mickislack]

Thanks for your thoughts on my jaw.  I will ask about it.  The flareups are very painful, but are not stabbing, its constant pain and yawning or eating a big mouthful will make it worse.  My doctor calls it TMJ, but I should see a nuero doc to find out if it is more. Thanks again and I will study up on what you mentioned.

[Ron3]

Hi Micki,

Has anyone ever called your jaw condition by its' likely name?
Tic Douloureaux sounds like it might be your problem.

You could try weraring a bite guard at night to prevent teeth grinding and the resulting headaches, sore jaw and damaging your teeth.

It is not required to spend a fortune on a teeth guard if you can get relief from a plastic hockey or sports device that is comfortable or even a less bulky teeth whitener appliance.
(As long as you find one that prevents the teeth from rubbing
and clenching while allowing you to breathe when needed.)

Here is a link..
http://www.drmirkin.com/morehealth/g172.htm

Take care...
Ron                                     ***@****

[CCF-Neuro-M.D.-JT]

Post-traumatic headache is unfortunately a common problem. In one study, they found that up to 25% patients still had headache 2-4 years after the initial injury.  Reportedly, the best method of management is aggressive multi-modality treatment consisting of behavioral therapy, stress management, biofeedback, counseling and pain medications. 85% patients in a study from 1992 reported that they were able to return to work with this comprehensive program.  Thus, it's not really a measure of how long you can have it, but rather how long it is before you may receive adequate treatment.

As for the cause, no one's quite sure but they feel that it is multi-factorial.  Changes in brain chemistry, neck-jaw-scalp injuries or dysfunction, actual brain tissue injury, genetic predisposition to headache, and changes in the blood flow to the brain resulting from the head injury are thought to be some important factors.

An important point is that your TMJ problems in themselves may be contributing to the headache, especially if it's an active issue at this time. The sooner you get the appropriate treatment/management for the TMJ, the sooner you may feel some relief from your headaches. Good luck.