facial pain and nose numb

  For some time now I have been getting headaches down the left side of my face, across the cheek and upper jaw, in front of and under the ear and behind, in and around my eye.  These headaches are very painful and I have not been able to get an explanation for them.  I noticed the other day when I had a headache that the left side of my nose had gone partially numb.  I do get odd tingling sensations there when my face is hurting, but I hadn't noticed numbness before.  Does this mean anything to anyone?  I don't know whether I should worry about it or not.
  Jule
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Thanks for your question.  The symptoms described in your messages could
potentially be caused a condition called "Trigeminal neuralgia".  It is
a result of the direct irritation of the cranial nerve, called Trigeminal
nerve, which provides the sensation for all of the face and anterior part
of the scalp.  In contrast with other headaches (e.g. tension-type headaches,
migraines), the pain of trigeminal neuralgia is usually described by
patients as extremely intense, sudden, "lightning-like", "sharp jabbs",
lasting only seconds at most, sometimes triggered by trivial events, such
as a puff of cold air to the head.  Medical management has included the
use of anti-epileptic medications, such as carbamazepine (Tegretol), ethanol
injections/block to the trigeminal ganglion.
Another explanation for the symptoms could temporo-mandibular joint
dysfunction (TMJ).  In this condition, the symptoms are worsened by
repetitive masticatory movement.  It can frequently be associated by
"bruxisms" (grinding of teeth during sleep), and present "jaw pain" in the
morning.
I would suggest that you be evaluated by a physician specialized in headaches.
If you live in the Cleveland area, the Headache Center at the Cleveland
Clinic has a group of neurologists (Drs. Gretter, Kunkel, and Yuska-Mays)
that are specialized in headaches.
If you wish an appointment at the Department of Neurology at the Cleveland
Clinic, please call 1-800-CCF-CARE, or 1-216-444-5559.
I hope this information is helpful.
This information is provided for general medical education purposes only.
Please consult your doctor regarding diagnostic and treatment options.