Is it TN, ON, or occipital neuralgia?

[ack65]

Hi all,

I've recovered from my horrific neuro appt and will be seeing my GP this friday as I continue to have this stabbing pain in my skull.  It started with a very stiff neck and headache and then this stabbing pain that comes momentarily, sometimes in my right eye, or the top, side(above the right ear) and back of my skull or in my teeth.  Feels like someone is driving a screw driver into my right eye or into various spots on my skull.  It is so painful it can bring tears to my eyes or I let out a bit of a yelp.

Along with this pain I have head a headache daily since Jan and my eyes hurt - like deep into the socket and it hurts to move them, read or look at bright things.  I had lots of vertigo in march but that has let up but the stabbing pain won't go away and happens numerous times a day.  My scalp is so tender to touch I haven't had my hair cut since Jan.

According to the "neuro" my c-spine mri looked fine.  Would that show TN or occipital nueralgia?  I saw a dentist in Jan - xrays...and no teeth problems to cause this pain.  I'm doing physio to losen up the neck and it is much better and I saw my optomotrist who said my eyes looked fine and yet the pain won't stop.  T-3's are all I have and they are not stopping it.

Anyone have any ideas before I go crazy?

[COBOB]

By the way, in more that 60% of optic neuritis cases, the ophthalmologist will see nothing wrong with the Optic Disc,  A majority of the Optic Nerve is inside the Cerebrum of the brain.  Optic Neuritis has a very specific diagnostic presentation 2-3 days of eye pain then a loss of vision and color perception with some pain on extreme lateral gaze of the effected eye.  VEP is the bet way to detect Optic Neuritis.   A good Neuroradiologist may pickup changes with an MRI of the Brain.  

Since the hair hurts, I move towards occipital neuralgia.  I have TN, and this is not typical al TN even in the First Branch of the nerve that innervates the forehead, the surface of the eye and up near the ear.  


Bob

[COBOB]

You might also want to have a look at this thread:  http://www.medhelp.org/posts/Multiple-Sclerosis/trigeminal-neuralgia/show/1389569

[COBOB]

You can do an online questionnaire to help differentiate the different kinds of facial pain at:  https://neurosurgery.ohsu.edu/tgn.php

[sangel]

sounds like the pain i go thru.. The first time Ive ever had this pain it came very suddenly and it was very intense. I suffered thru this pain for 4 days, I was so sick I could barley get out of bed, could not keep anything down. I wanted to die. I decided to go to the quick care to see if they could make it go away. Because no matter what I did and no matter how many pain meds I took, It was still as intense as when it started. The quick care sent me to the hospital, (i didnt understand why they were sending me to the hospital for a headache, and I was honestly annoyed) They did an MRI and a cat scan, they found a small lesion, and told me it looked like I had a stroke but I had no synptoms.. He also said he wanted to do a spinal tap, I at first said no way.. But he told me that that was the only way they would be able to find an infection. I finally agreed after my mom cryed and said she didnt want me to die... well the test results came back positive. Viral Menigitis.
Ever since I have had horrible headaches, I was told I have a combination of headaches and migranes, and was diagnosed with occipital neuralga. I belive caused by the meningitis.

[steph74]

Sounds a lot like the pain I've had.  I think it's TN and occipital neuralgia.  I've also had what I think was a very mild case of ON and the pain was really different--right behind my eye and it hurt with movement.

What you're describing really does sound like TN and Occipital N to me.  The only things that have helped were IV steroids followed by titrating up on neurontin (I've since switched to Lyrica, but they both work well).  The dosage necessary to deal with the pain are large for me, and it took a while to get up to them (going slowly to avoid side effects), but it was well worth it.  If I stop the meds, the pain comes back and it really s*cks.

I hope you find some relief soon.

Stephanie

[biowham]

Ack--

No, a cspine MRI wouldn't tell you anything about your eye pain. You might consider requesting at the least a referral to an ophthalmologist (NOT an optometrist) so that they can examine your optic nerve and other features of the eye. I'd suggest seeing a neurologist, given the headache history, but you just did that.

A stiff neck can be a sign of meningitis, but that's acute, and you'd...um...know by now if that were it.

As for whether your experience is TN, ON, or occipital neuralgia...that's something that the ophtha exam may help to determine, although a brain MRI would also be indicated, in my opinion, if the doctor doesn't conclude migraine or something.

Bio