Undiagnosed Neuropathy

    
      Re: Undiagnosed Neuropathy
    


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Posted by CCF Neuro MD on May 21, 1997 at 16:38:23:

In Reply to: Re: Undiagnosed Neuropathy posted by abros on May 05, 1997 at 16:34:14:

: : About 1.5 years ago my left face beside the nose, in the cheek started to hurt. Thinking it was my teeth I went to the dentist. She did 5 root canals before she sent me to a neurolgist The CAT scan and MRI were clear. The pain is dull and constant. However it does feel like nerve pain. Neurontin and Tegretol do not seen to alleviate the pain. However during this time I had a rollerblanding accident and was hit in the head sustaining a concussion. After this I had two lower molors pulled and am undergoing implants currently. Muscle relaxers seen to help. Any input on a diagnosis? My whole family has sinusitus, however I dot have any symptoms of this. However when I insisted on a boone scan it showed sinus infoection.
  I should also mention that I noticed the face pain beginning shortly after my husband had a nasty bout with Shingles.
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Hello:
The type of symptom that you have described would best fit under the category of diseases termed atypical facial pains.  They are characterized as atypical when they don't fit into the classical description of neuralgic facial pain as seen in trigeminal neuralgia.  This type of pain is characterised as brief sharp shooting pain over the lower face brought on by such things as brushing the teeth, a light touch over the face etc.  Any other type of pain is atypical and this includes constant dull pain over the face without any obvioius triggers.  There are many posssible causes for atypical facial pain but often after an exhaustive search there maybe no identifiable cause found.  When this happens the main challenge for the treating physcian is to try and control the pain as well as possible with medications.  The typical medications used are amitryptilline, tegretol, pamelor, neurontin, and occasionally blacofen.  It is important that a evaluation be performed to look for other medical causes which could cause face pain like sinusitis, TMJ, or periodental abscess.  Post-herpetic neuaralgia which occurs in setting of shingles typically presents with a rash which heals and afterwards a pain develops in the region of the rash. I would suggest that you seek advice from your neurologist concerning the question of diagnosis and treatment.  If you would like a second opinion from the Cleveland Clinic call 216-444-5559. Good luck.