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Neurology  (Expert Forum)
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atypical facial pain, help needed
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atypical facial pain, help needed

by Brian-Jones, Jul 20, 1998 12:00AM

  My wife has suffered facial pain for 23 years, which has worsned over the
  past 5 years to become debilitating. Her symptoms are very like TN but
  there is no remission except when she lies down.
  There is intense pain in her upper jaw which started after repeated work and
  teeth extractions to relieve lesser pain.
  The situation is becoming critical because of the amount of medication she
  takes. The main agent the keep her on her feet is parstelin, she also takes
  mixtures of paracetamol and codine, anti-depressants, (constant pain is
  depressing,) sleeping tablets, and the situation is becoming dangerous
  according to her GP.
  When she wakes in the morning she has a severe headache and has to get up,
  after a few minutes the pain in her jaw begins to build and she has to sit
  and take her medication until the level allows her to function. The headache
  usually goes away and leaves only the intense throbbing pain in her upper
  jaw. Alcohol can give her relief sometimes after she has used up her tablet
  quota, (is this worst than pills?).  
  She is not allowed to drive because of the medication and is virtually
  housebound as she cannot manage to go out alone because of loss of balance.
  Medical resources in Norway are expensive and limited. We have tried, many
  pain killers including tegratol, acupuncture, healers, physiotherapy,
  kiropractors, neurologists, ENT specialists, dental specialists, and
  most recently EMF in the neck area. Nothing shows on CTs or X-rays, (only
  extra activity using radio active isotopes) there appears to be no infection.
  My wife urgently needs a better diagnosis and some alternative treatment
  that will work.
  I would take anywhere, but my wife has lost hope and has a problem to face
  more treatment followed by more disappointment. She can only be persuaded
  to travel locally, anything else would have to look certain.
  I am sorry if this is too long but it is only a summary of the treatments
  and events that led us to this situation.
  Any help or suggestions would be gratefully received.
=
I am sorry about the delay in responding to your post.
Your wife is indeed unfortunate, and I'm not sure exactly what to recommend. Clearly, she has been evaluated sufficiently to rule out causes of pain with different treatment. Pain management for atypical facial pain is very difficult.
I don't know if pain management specialists are common in Norway. That's the only thing I can think of right now. You've mentioned several medications I have used for some of my patients, so you need more expertise than a neurologist is likely to provide.
I hope this helps, wish I could offer something concrete. CCF MD mdf.





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