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Originally Posted by cloudsnapper
So, I went to the ENT last week and he was like "Lol, why'd your neurologist send you to me? It usually works the other way around." and he pretty much didn't know what to look for. But he said I probably have the start of TMJ or a mild case of it, but made sure to say that he wasn't second-guessing the neurologist's diagnosis and even said that I could have gotten it from holding my face weird from having pain.
He also that I should have nose surgery because my septum is deviated and I have really large turbinates  It would be cool to be able to breathe through my nose, though!
I got him to refer me to another neurologist who my aunt either used to transcribe for or it was the one she saw for migraines. Either way, she seems to think he's pretty great. I haven't gotten an appointment time yet, but it hasn't been even a week and I know doctors' offices are busy. |
I'm glad you are getting to see various doctors. I thought the referral to the ENT doc was unusual, though it sounds like it was a good thing for you if you have a deviated septum. I don't know if that would contribute to the pain... A diagnosis of TN is considered confirmed when a medication for seizures like Gabapentin takes the pain away. But of course the pain can escalate so that you need to increase the dose. A regular MRI is usually just to rule out other possible diagnoses. There is a special MRI that can spot places where blood vessels are pressing on a nerve. That is probably the major cause of TN.
Here's a description I found on a neurosurgery site:
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The conventional MRI scans used to rule out the presence of a brain tumor or multiple sclerosis as a cause of a patients face pain are not adequate to visualize the trigeminal nerve or an associated blood vessel. Fortunately, the continued improvement in MRI neuro-imaging now makes it possible to visualize both. The technique, which is called 3-D volume acquisition, is performed with contrast injection and utilizes thin cuts (0.8mm), without gaps similar to what was developed for MRI angiography and venography. The trigeminal nerve is easily visualized in the axial plane when the MRI series is centered at the midpoint of the fourth ventricle. To ensure an adequate evaluation, the nerve should be seen on three adjacent cuts. Early studies indicate that when an offending vessel is present it will be detected 80% of the of the time. With continued imaging improvements this percentage will definitely increase.
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