Constant dull frontal headache/facial pain for nine months

[chapter11studios]

I've been suffering from constant dull pain/pressure around my nose/forehead/sinus for about 9 months. It's accompanied by a runny nose, congestion, and post-nasal drip (maybe an allergy?). I'm pretty sure the runny nose, congestion, and nasal drip were present long before the pain, however.

Since this began I have seen two ENTs. Neither thinks I have a sinus problem (both ordered CTs of my sinuses that came back normal). I've also been on a series of antibiotics prescribed by my primary care doctor and these have not helped at all, except for one occasion when I really did have a sinus infection. However when that cleared up the facial pain/pressure remained.

One of the ENTs says I have a slightly deviated septum. He also observed that my turbanates were inflamed and prescribed Nasonex. When I returned for my follow up appt a month later, the pain/pressure had not improved at all, but the ENT declared me "all better" because my turbanetes were no longer inflamed. Could the pain still be related to a sinus/nasal/allergy problem that the ENT is missing?

I have also been to see a neurologist. She ordered a CT of my brain, which came back normal. She thinks it might be attributed to muscle tension, and prescribed me amitryptoline (no improvement after several months) then later inderol (also no improvement after several months). Is it really possible that this is muscle tension? I've never heard of *constant* muscle pain like this.

Around the same time that this started my basement flooded and later we found some mold growing there after the cleanup. We removed the affected areas, but I'm not 100% positive the basement is mold-free. Could this have something to do with mold?

Lastly, I am a frequent traveler and in the months prior to onset of symptoms I visited the Caribbean, Chile, Malta, and Iceland. It seems unlikely, but is it possible I picked up some kind of weird parasite or other problem in my travels?

[Kevin Pho, MD]

You have had a comprehensive evaluation for sinus infections, including a CT scan and several ENT referrals.

I agree with the Nasonex.  Sometimes systemic steroids can be helpful as well in cases of acute rhinitis.

If the sinuses have been rule out, a neurology referral indeed can be considered.  A normal CT scan would rule out things like brain masses, but an MRI can be considered for a more thorough check.  

Allergies can be considered if the tests continue to be non-revealing.  You can consider a referral to an allergist.  Testing for mold can be included in the allergy testing panel.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[ozark]

have they thought of maybe some type of migraine, especially with the runny nose, congestion and a neg CT?  just a thought

[Kldyk513]

Just so you know, I get a lot of sinus infections however I suddenly had a very bad headache on the right side of my head that shot into my face. It went on for weeks and my Dr thought it may be Atypical Facial Neuralgia. Neuro & ENT appt later, plus CT head, Brain MRI all clear the Neuro said I have a pinched nerve in my neck. The pain is always there but manageable however I came down about 3 weeks ago with a bad sinus infection and the pain in my head came back horrendously with bad burning in my head & into my face. My doctor wants me to get a 2nd opinion as he believes I do have either a nerve inflamtion or damage. Hope this helps.

[laurel10]

I have EXACTLY the same thing that you're describing.  The only difference is I often feel really tired in mid-afternoon everyday.  

I too, have seen ENTs and a Neurologist and all have come up with nothing.

[laurel10]

One more thing, I also have had moccasin type athlete's foot for quite awhile and think it is on my hands as well.  Was thinking this maybe has something to do with the whole Candida overgrowth thing.  

[Shelly438]

Hello There

This is whats happening to me!!! Do you ever get slight nasal burning sensation too? Do you also get slight pressure in front of your ears?

My sinius CT showed only a slight thickenening which ENT is convinced not enought to give me the facial pressure/pain on a daliy bases!