Neuralgia of the Head and Neck

[ncowleyc]

Hello, I have been experiencing pain for over a month now in my throat and head. I have Trigeminal Neuralgia, which was diagnosed last year. I have had pain in my throat for a few years now that comes on every summer it seems. Talking makes the pain come. It starts in the right side of my throat and extends down to the top right of chest and goes up to my ear into the top and bottom of my mouth into my tongue, all on the right side. It makes my TN start with pain in front of my ear to my top and bottom teeth and into my temple and nose. The pain is sharp, stabbing and comes and goes with burning in between episodes. I have been using cepecol lozenges and throat spray which help but only for a little while. It seems if I take cepecol I can stop a full blown attack. I have been to the ER three times since the start of July and was given medicine for TN and Strep. The steroids helped for a while but pain came back when I stopped taking them. They gave my vicoden which did not touch the pain then Percocet which took away 80 percent of the pain. Third time at ER they suggested an ENT. Went to Ent and he did not find anything in my throat to cause this. He did say I have Thrush by looking at my tongue. I disagree with his diagnoses. I had been using lemon cepecol and could not brush my teeth for awhile so my tongue was coated with yellow. I brushed my tongue later and switched to cherry. My tongue went back to normal color. The pain has been very debilitating. Afraid to talk. Tongue sore from lozenges. And sometimes pain on right side is joined with same pain on left but milder and shorter duration. Now I am stumped. Is this pain in my throat nerve pain? I have looked up glassopharengeal neuralgia. Seems to fit. What do you think? If so then what could cause this pain? Should I make an appointment with a Neurologist? No insurance so I would have to pay out of pocket. Want to make sure the neuro can help. I want this pain gone, NOW! Thank you.

[nanabetty1959]

i have neuroligia on the top of my head (left side) - constant burning 24/7. i have had it since 1996 and doctors treat mine with depakote.  this really does stop the pain.  however if for some reason i have to take an antibotic this usually interferes with the depakote and the pain comes back but for the most part i am pain free with the medicine.

[Christopher R Newey, DO]

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 a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Glossopharyngeal neuralgia has a similar pain sensation as that of trigeminal neuralgia. This type of neuralgia is rare and is usually one sided. The pain can be felt in the throat, tonsillar region, back of the tongue (not front), and even the ear. The pain can be triggered by various activities such as laughing, chewing, coughing, speaking, etc.

The treatment is similar to that of trigeminal neuralgia. Medicines such as carbamazepine and phenytoin have had some success. Surgical decompression of the nerve is an option if the pain continues despite optimal medical treatment.

I agree that your symptoms do fit this neuralgia. However, the thrush is interesting. Did the ENT scope your throat to ensure that the thrush was just on the tongue?  If so, I would suggest that you do see a neurologist that specializes in headache and pain syndromes to accurately diagnose your condition and also properly manage the pain syndrome.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.