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recurrant severe facial pain

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milsochilso

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recurrant severe facial pain
Posted: 03-13-08 18:20pm

I am going to the doctor about this tomorrow (finally!), but I am interested to hear other people's perspectives and anyone who has experienced anything similar.

I had never had any facial pain or ear pain prior to December 2001 when I was in my final year at college and I contracted a severe virus, which affected my ears and face.

Since then, I have had recurring episodes of extremely severe facial pain - to the point where I have wanted to take my own life. It is really starting to affect my life... work is very difficult due to either the unpredictable pain or lack of sleep and I cannot make plans to go places because I never know when a fresh wave of attacks is going to happen.

I have been to the doctor twice - they suggested sinusitis and sent me away with antibiotics. When another attack started I began to visit my dentist as a large proportion of the pain was focused on my right upper molars and I thought something was wrong with them or I might have an abscess. Anyway, my dentist gave me more antibiotics because he could not find anything.

The latest attack began about a month ago. I woke up in the early hours of the morning with this feeling of intense pressure in my right cheek and a heavy feeling in that side of the face. The pressure was replaced with the most excrutiating pain, which continued on and off for days. It feels like an aching feeling combined with sharp shooting pains. I thought maybe I was getting a cold or something so I waited 5 days, taking massive doses of painkillers, but nothing seemed to hit the pain. I would want to cry with pain, but couldn't even manage that. During an attack I cannot do anything. I cannot lie down as it makes it worse. I find eating very difficult as well as speaking/using a telephone or even concentrating on anything. The muscles in the right side of my face feel very tense during an attack, almost like they are cramping. The attacks usually last for a few hours at a time. They seem to occur at certain times of the day more than others. The late afternoon/evening and night are worse... from about 2 or 3 AM onwards is not too bad.

I booked in to see the emergency dentist who took X-rays of my teeth/cheek area and tapped the teeth, made me bite on things, blew air all around the teeth - NOTHING.

Anyway, he gave me 2 doses of antibiotics to take side by side and said to continue on the painkillers. I do not think the dentists understand the meaning of the pain I am experiencing!! I came back to my regular dentist a week later and he examined me - lots of tapping, air blowing, X-ray examining... he said: there's nothing wrong with the teeth and I am not going to do a root canal or extraction on a tooth which I can see nothing wrong with. He told me to go away and come back if the tooth hurt when I touched it with my finger or bit on something.

I have not gone back to the dentist because although I feel pain in the teeth area - I do not feel pain on application of pressure or touch.

So... I continued. After years of this, I think I have got this kind of resignation and high tolerance of pain. I find it hard to take the time off work to go see the dentist or doctor so I have been trying to cope as best I can.

Now I have got to the end of my tether finally. The pain has become less localised in the upper right back teeth and has now become more generalised. It seems to focus from around my jaw hinge on the one side and spread down to my lower jaw and my upper teeth, then up towards my eye and back towards my ear. The pain is still extreme aching pain topped with sharp stabbing pulsations. Teeth feel fine to touch. No feeling of pressure in my face. My eye hurts if I press against it (like if my eyelid is closed). I feel a numbness when touching my cheek/jaw area and pins and needles/prickling sensation - to the point where touching my face made me feel physically sick.

If I go to bed at night - an attack starts about 11:30 and goes on until 2 or 3 in the morning. I finally get to sleep then have to get up for work at 6:45 a.m. Sometimes a further attack starts around 7:30 a.m. otherwise I can continue to maybe lunchtime before another one threatens. The worst time is around 5 p.m. onwards.

I have taken at times, in addition to painkillers, anti-allergy tablets, sudafed, beconese, used neilmed sinus rinse, homeopathic sinusitis tablets, luffa complex. Nothing has made any inroads to resolving the situation.

I am sorry this is so long and I hope that it makes sense.
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MandMs

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Hi!
Posted: 03-21-08 06:53am

Reading your post, I started to suspect about two possible conditions.
For all these years, have you been having several headaches a day for weeks, sometimes months, usually interrupted by a pain-free period of variable length or this is everyday pain without pain-free period?
Have you experienced a beginning of headache as a burning sensation on the side of your nose or deep in your eye?
Do these headaches usually come on just after you go to sleep?
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milsochilso

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Posted: 03-24-08 16:56pm

Thank you for your reply.

It's not a really what I would class a headache - it's facial pain in the right hand side.

It seems to come for periods of time and then disappear. These periods of time could be several days or several weeks. When it is gone... I am pain-free and take no painkillers.
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milsochilso

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Posted: 03-24-08 17:02pm

I forgot to say - usually it starts when I am asleep... or when I wake up I notice it is there. Then it goes on for weeks... with several long episodes a day rather than a continuous pain.

I have never had a burning sensation. It is more of a throbbing or gnawing feeling with sharp stabbing pulsations over the top of the baseline pain.
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MandMs

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Posted: 03-27-08 07:22am

Is this facial pain, usually, triggered by a light touch of the face or mouth?
Do you often find yourself afraid to talk, eat, or move during periods of attacks?
Do you wince involuntarily when you feel the intense facial pain?
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milsochilso

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Posted: 03-27-08 17:39pm

I have not noticed that it is triggered by anything in particular, but I am afraid to talk, eat and move during the periods of attacks as these seem to make it a lot worse. It is so bad that it is more than wincing, it is the most gripping and terrifying pain I have ever experienced. It has made me feel extremely desperate.
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antigone

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Posted: 03-28-08 02:40am

I am a neuro RN. This sounds like it could be trigeminal neuralgia. A viral infection can trigger the neuralgia. If you do not get any help with your doctor consider seeing a neurologist. There are treatments available. This can be an excruciating condition. I hope this helps. Let us know how you do with the doctor.
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MandMs

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Posted: 03-28-08 04:48am

This severe, stabbing pain that you feel on one side of your face, that is one of the most painful conditions and makes wince involuntarily (hence the term tic) is known as tic douloureux or trigeminal neuralgia. These painful attacks can be spontaneous, but they may also be provoked by even mild stimulation of your face. Acctually, is a neuropathic disorder of the trigeminal nerve (it is responsible for sensation in the face) and the pain you feel is in areas innervated by this nerve, that has three main branches.
The first branch is ophthalmic nerve, responsible for sensory information from the scalp and forehead, the upper eyelid, the eye, the nose, the nasal mucosa, the frontal sinuses, and parts of the meninges (the dura and blood vessels).
The second branch is maxillary nerve, carries sensory information mainly from the lower eyelid and cheek, upper lip, the upper teeth and gums, the nasal mucosa.
The third branch mandibular nerve, carries sensory information from the lower lip, the lower teeth and gums, the floor of the mouth, the tongue, the chin and jaw, parts of the external ear.

The exact cause of this painful condition is not known, but, there are several theories for its etiology.
As you said in your first post, you noticed this after having an infection.
One of the theories states the same that some infection can cause the nerve damage. But, don't get this as a final answer.
In most of the cases it is due to contact between a normal artery or vein and the trigeminal nerve at the base of the brain, placing pressure on the nerve. This is some kind of genetic and runs in families.
Other reasons to have this conditions can be due to bone abnormalities, trauma or multiple sclerosis.
You should visit neurologist as soon as possible, because remission is less common the longer you have trigeminal neuralgia.
This pain can be treated with medications (anticonvulsants, antidepressants, nerve blocks with anesthetics) or surgery.

Best wishes!
Marija
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