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TNA and Severe Headache
I am a 30 year old FM recently diagnosed with Trigeminal Neuralgia.  Every time I get an attack it is preceded by the MOST intense bilateral temporal headache and I can't find much about this particular symptom in others.  Tegretol works wonders for the shock-like typical facial pain I experience but does nothing for the headache.  Would a prn migraine medication (is there such a thing?) or other treatment help me with this symptom?  Thank you in advance for any response, Lindsay  
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Hi,
How are you feeling now?
The Pain which is severe in nature, stabbing type, lasting for few seconds to minute and which has a triggering factor to it describes pain of trigeminal neuralgia. Physical examination of the patient is normal.
Comprehensive pain management care is helpful.
Carbamazepine is drug of choice, but along with Baclofen it serves good result for episodic pain. There are other newer anti-convulsants like toprimate which could be tried, but it depends on neurologist comfort with the drug.
You can be started on opoid analgesics if headaches are severe.
I think you need to discuss and consult with neurologist regarding starting treatment for headache.
Hope this helps.
Bye.
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I have been under the care of a neurologist for awhile, but as you know - the longer you have this disorder the more you begin to notice patterns.  I've been noting these headaches over the past 6 or so attacks.  I really need a prn prescription -as I have been making regular visits to the urgent care for relief and I can only get there with someone else driving.  The pain is that intense.  Well, knock wood- I only have an attack 1 or 2 times a month.  I'm considering myself lucky and trying not to dwell on the negative.  I am going to contact my neurologist BEFORE I experience my next attack.  Thank you, Lindsay.
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