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diagnosed with trimengial neuralgia
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diagnosed with trimengial neuralgia

My neck and face are numb, sometimes the numbness is more in the morning.  Diagnosed  with gastroparesis and esophagial spasms I get neck pains and cramps. I sleep sitting up due to two things esophagus spasms and swelling of neck.on gabapintin and a antiseizure medication.
If I sleep regular I swell and look like a bull frog v croaking.  It's less if I sleep sitting up. Clean Crazy MRI s I need help to find out what I'm dealing with.
Avatar_dr_m_tn
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.

Trigeminal neuralgia is a disorder that usually occurs in middle to later in life. It consists of instense, stabbing pain in the distribution of the fifth nerve (typically around the jaw bone and cheek). The pains occur quickly but can recur. The pain may be stimulated by activities such as shaving or brusthing teeth. Sometimes even talking, chewing or yawning may cause the pain. The cause can be idiopathic in that we do not know, or may be related to multiple sclerosis, tumor, or basilar artery aneurysm. The treatment includes anti-seizure medications such as carbamazepine. Other treatment options include baclofen and even surgery if indicated.

Based on your history, have you been evaluated for other possibilities including small fiber neuropathies (which could affect the autonomics causing gastroparesis)? The diagnosis of these can be difficult. The EMG/nerve conduction studies (NCS) (tests done to check for neuropathy) will not show an abnormality, and a definitive diagnosis can only be made with a skin biopsy so that the number of nerve endings can literally be counted. There are other tests of the function of small nerves that can be ordered, such as QSART testing which looks at how much sweat the skin makes, since sweating is in a sense of function of these small nerves. There are several causes of small fiber neuropathy, including diabetes, vitamin deficiencies, and autoimmune problems.

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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