burning pain in head and face

[mrsclark75]

My mother has severe burning type pain in her head and face, her head is sensitive to touch to the point she can't lay her head on a pillow.  she can't sleep, her face and head hearts her severly!!  she describes it as a burning type pain and as being unbearable.  She has had MRI's, CT scans, EEG's, blood work etc.. and everything comes back "normal", her quality of life is low.  has anyone ever experienced this or know what this could be?  her Neurologist has been "trying" all kinds of meds, most recently he put her on a medication that treats patient's w/ severe seizures this made her sick and worst.  !!  help!!  

[nanabetty1959]

i have severe burning on the left side of my head 24/7.  i have had this since 1996.  a neuroligist put me on depakote which really does help with the pain.  however if i take an antibotic that seems to interact with the depakote and i get the pain for the duration that i am on the antibotic. but pretty much i can leave a normal life, pain free, as long as i take my depakote.  

[Christopher R Newey, DO]

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 of your mother, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

There are several “common” pain syndromes of the face other than headaches. One is a condition called trigeminal neuralgia. This is a type of pain that comes and goes on one side of the face and is severe and sharp when present. When there is no pain, most people are symptom free. It is in the distribution of the trigeminal nerve, hence its name. The pains are usually on the cheek and jaw regions. It usually occurs in people older than 50 years of age. Triggers can include washing the face, shaving, smoking, talking, brushing teeth, etc. The cause is unknown but the thinking is that it is from compression on this nerve. The diagnosis is largely clinical. MRIs may be obtained to rule out other causes or to attempt to identify a cause for the pain, but these tests are most often normal. Treatment includes medications, such as carbamaezpine, gabapentin, and topiramate, that are used in treating seizures. Many pain medications have indications other than pain treatment. Other options include baclofen or clonazepam. If medical therapy is failed, a referral to a neurosurgeon may be an option for consultation regarding trigeminal nerve decompression or radiofrequency ablation.

Another condition that should not be overlooked is called giant cell arteritis or temporal arteritis. This condition is due to an inflammation in the temporal artery and other arteries in the body. Symptoms include one sided headache pain in the temple and jaw that may be triggered by chewing. This condition can be diagnosed by a blood test called an ESR and a biopsy of the artery. It is very important to rule this diagnosis out since it is highly treatable and if left untreated it can lead to vision loss. It is exceedingly rare in people younger than 55, and is more common in even older age groups.

I recommend that you and your mother continue working the neurologist. Pain conditions are difficult to treat and may take time.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.