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Neurology (Expert Forum)
The right side of my face hurts
Answered by
Lama Chahine, MD - Neurology
Cleveland Clinic
Cleveland - OH
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.
The right side of my face hurts
by myfacehurts, Oct 31, 2009 08:44AM
I am a 45 year old woman.I have had intermittent painful burning, tingling, and sometimes a numb cold feeling on the right side of my face, over my eyelid, sometimes in my ear, and all along the side of my jaw since 2004.The first time I had this I was rushed to ER thinking I was having a stroke.
These episodes are becoming much more frequent and more painful rather than only tingling and burning.
I have seen an ear nose throat doctor, neurologist, dentist, and my regular doctor off and on for this. No help, no diagnosis.
One and one half weeks ago after I began brushing my teeth the pain was so intense, and lasted 3 days, I finally had to rush to the ER. I was to the point that the pain made my nearly vomit.
The ER doctor gave me pain meds, did an MRI and indicated to me that he thought this problem was likely a nerve issue and that I needed to see a specialist.
I currently have the burning and tingling sensation in my face as I write this question. Last night after showering I began to feel pain start to gain in intensity so I took the percodan and ibuprofin the Dr. prescribed and fell asleep.
I am at wits ends here. Can you help??? Please, Please, Please!!!!
These episodes are becoming much more frequent and more painful rather than only tingling and burning.
I have seen an ear nose throat doctor, neurologist, dentist, and my regular doctor off and on for this. No help, no diagnosis.
One and one half weeks ago after I began brushing my teeth the pain was so intense, and lasted 3 days, I finally had to rush to the ER. I was to the point that the pain made my nearly vomit.
The ER doctor gave me pain meds, did an MRI and indicated to me that he thought this problem was likely a nerve issue and that I needed to see a specialist.
I currently have the burning and tingling sensation in my face as I write this question. Last night after showering I began to feel pain start to gain in intensity so I took the percodan and ibuprofin the Dr. prescribed and fell asleep.
I am at wits ends here. Can you help??? Please, Please, Please!!!!
Doctor's Answer
by Lama Chahine, MD, Nov 01, 2009 02:08PM
, Nov 01, 2009 02:08PM
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.
Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.
Your symptoms may be consistent with a disorder called trigeminal neuralgia. The trigeminal nerve (also called cranial nerve 5) is the nerve that supplies innervation to the majority of the face, in addition to having some other functions. A problem with this nerve arises either for no apparent reason (what is termed "idiopathic"), or due to a small vascular ring around the nerve, or in some cases due to demyelinating disease (such as occurs in MS), and less commonly due to a tumor pressing on the nerve. The latter causes can be largely investigated using MRI of the brain with specific sequences, and MRA.
The symptoms include pain in the face, ranging from mild twinges to severe stabbing, shooting pains. They typically occur in the same part of the face and may be triggered by touching the face, brushing the teeth, chewing, or other triggers.
Another name for this disorder is "tic douloureux". This condition is treatable with various medications, some of which are seizure medications (trigeminal neuralgia is not a seizure disorder, it's just that some of the medications used to treat seizures treat the pain of trigeminal neuralgia as well). When these medications are not helpful, other medications can be used, and in some cases, surgical therapies are available as well.
There are a few other causes of facial pain, most of which relate to a problem with the trigeminal nerve.
Evaluation by a neurologist is recommended.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.
Your symptoms may be consistent with a disorder called trigeminal neuralgia. The trigeminal nerve (also called cranial nerve 5) is the nerve that supplies innervation to the majority of the face, in addition to having some other functions. A problem with this nerve arises either for no apparent reason (what is termed "idiopathic"), or due to a small vascular ring around the nerve, or in some cases due to demyelinating disease (such as occurs in MS), and less commonly due to a tumor pressing on the nerve. The latter causes can be largely investigated using MRI of the brain with specific sequences, and MRA.
The symptoms include pain in the face, ranging from mild twinges to severe stabbing, shooting pains. They typically occur in the same part of the face and may be triggered by touching the face, brushing the teeth, chewing, or other triggers.
Another name for this disorder is "tic douloureux". This condition is treatable with various medications, some of which are seizure medications (trigeminal neuralgia is not a seizure disorder, it's just that some of the medications used to treat seizures treat the pain of trigeminal neuralgia as well). When these medications are not helpful, other medications can be used, and in some cases, surgical therapies are available as well.
There are a few other causes of facial pain, most of which relate to a problem with the trigeminal nerve.
Evaluation by a neurologist is recommended.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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