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Right sided throat pain with right eye twitch
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Right sided throat pain with right eye twitch

Hi There,
I am 61 yrs old with a history of smoking (I recently quit)
For the last 2 weeks, I've had a pain in my mid right throat area. It's pretty much constant now, intensity comes and goes from a 2 to a 6. The last few years, i've developed concretions on either side of my upper throat that I can see and releive the pressure/discomfort of them with a dull probe to the side of it.  This I can see with a mirror.  I have not had these recently, but have developed this pain lower on right side.  My throat looks good.  I got a cxray with was normal. My airway of the right side is more open than the left.  I had a little discomfort in the upper right lung area which is less now, but I've have some twitching to my right eye for the last few days which comes and goes.  The only ENT in my town can not see me until late Sept.  I've been gargling with warm salt water.  It doesn't particulary hurt when I swallow, seems like there's something in my throat that is effecting that side of my head and chest. I have no fever, no bleeding or drainage. I am a home health nurse and transfer a 70 lb child maybe 15 times a shift (I work 3 days now)
Any suggestions on what this could be, and should I just go to the emergency room to evaluate as my PCP sent me to the ENT who is not available.  My lymph nodes are not swollen.
Any suggestions on what this could be
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147426 tn?1317269232
First, this is not my area of expertise.  I've tried, but I can't answer the pain in the throat and the twitches in the eye with one answer.  They could both be cranial nerve problems.

It seems your major complaint is almost constant pain on one side at the back of the tongue and the throat.  Is this correct?  Does the pain radiate into the neck?  And swallowing does not make it worse??

Do you have any difficulty initiating a swallow?  Is there anything that brings on precipitates worsening of the pain?  Coughing, eating, cold liquids?

One possibility for this pain is a condition known as "Glossopharyngeal Neuralgia".  This is caused by irritation of or compression of the IX cranial nerve, the hypoglossal.  It is excrutiatingly painful by the same mechanism as "Trigeminal Neuralgia"  which is more common and caused by problems with the trigeminal nerve.  Other effects in this pain syndrome can be excessive salivation, coughing and sometimes pain in the neck.  There are different types of effective relief for this.

I don't know about the eye.  Isolated bouts of eye twitching are fairly common and usually benign.  Where is the twitching with regard to the eye?  Does the twitching forcibly close the eye?  Do other muscles in the facial also twitch or droop?  This would indicate a problem with cranial nerve VII - the facial nerve.  If the twitching is starting to involve the rest of the side of the face it could indicate a condition called "Hemifacial spasm."

Then there is your history of smoking which could have caused oral or throat cancer.  Pressure from a tumor could cause dysfunction on multiple cranial nerves, though the VII and the IX are close, but do not run adjacently.  

Personally, I do not think you should wait three months to have this checked out.  Is there a town or a city nearby where you could see an ENT specialist sooner?  Another possibility is having the pain evaluated by a neurologist.  They could determine if it looked like a compression syndrome of the glossopharyngeal nerve.

Your history of concretions often indicate a prior history of tonsillitis.  But if there were active infection (like an abcess (abscess)) in your throat, like you, I would expect some swollen nodes.  I think you need to find a way of being evaluated sooner.  Good luck, Quix
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