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Posted by CCF Neurology MD on October 21, 1997 at 20:33:46:
In Reply to: facial nerves posted by JHN on October 14, 1997 at 19:58:47:
: I had Bells Palsy 20 years ago that I never recovered from. My right eye is still partially closed, I wink when I check and have less feeling on the right side of my face. About ten years ago I began experiencing pain in the right side of my face. After several years I was told I had trigeminal neuralgia. I take tegretol when the pain is sever and it tones down the pain to a nagging ache. My balance is off, my vision not 100%, I have trouble putting into words what I am thinking, have trouble remembering, etc. When I am not experiencing sever pain and just a constant nagging and I take the tegretol I am completely disoriniated and non functional. I have tried neurotin and two other drugs but they have the same effect. I have been experiencing the same pain in my arms and legs lately. I can take 600 mg of motrin every six hours and it seems to help the nagging pain as long as I take in every six hours. I have had MRI's and all kinds of tests done and everything looks fine. I need to find some answers to what is wrong with me and some solution to my pain besides taking tegretol and being unable to function. I want to enjoy life not waste it away in a stooper! Thank you for any help you can give me or in any direction I can investigate for answers..
Your history is atypical for a "garden-variety" trigeminal neuralgia. The fact that you have had a remote cranial neuropathy (Bell's palsy), and that you have persistent numbness on the face, and imbalance of gait, is concerning for an underlying unifying neurological (yet undiagnosed?) cause. Possibilities in this situation include MS (less likely with a normal MRI), vasculitis, indolent meningeal affection (such as from sarcoidosis or Lyme disease), tumor, dural AV fistula, and numerous others.
While most cases of trigeminal neuralgia are treated with medications of the type you are on, some patients are intractible and require invasive procedures such as surgery, injection, or gamma knife.
It is critically important to exhaustively search for all possible potentially treatable underlying causes of cranial neuropathy in your case before contemplating any major invasive or destructive procedure for treating your neuralgia.
The Cleveland Clinic departments of neurology and neurosurgery offer comprehensive diagnostic and therapeutic services ideally suited for cases like yours. Appointments can be made by calling (800)223-2273, or (216)444-2200 locally.
This information is provided for general medical information purposes only.
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