Is this trigeminal neuralgia?
 

Hi All

I'm a 41-year-old Asian male and new to this forum.

I've been having neurological symptoms over the past year. Random, fleeting twitching all over my body, shooting pains and dull aches, also all over my body, and pins and needles sensations on my arms and legs. I had a head/brain MRI in June this year and it was normal except for bilateral maxillary sinusitis. A cervical spine MRI indicated probems with the C3-C4 and C4-C5 vertebrae. Apparently the shape of my neck is also not normal. I've been examined by two general neurologists and they said my reflexes and strength levels were normal.

In the last two weeks or so, I've had random and fleeting face and head pain. Most of the time it is fleeting, dull, pressure-like pain, a few times it feels like mild electric shocks. Usually the pain comes without any stimulation but a few times it has come when I tap or squeeze a certain part of my face. I have to tap/press pretty hard to elicit the pain. A few nights ago, I tapped the area just under my right eye and I felt mild electric shocks on the right-corner of my mouth. But I get the pain on the left side of my face too, my chin, lower and upper jaws, temples, scalp, the back of my head and occasionally, tongue. Pain/shocks last for three or four seconds and goes on from the time I wake up until I go to bed. Sometimes the pain goes all the way down to my right toe. The pain is tolerable but I feel tired all the time and my head feels 'heavy'. My left cheek feels slightly numb/heavy. My face feels tingly and I sometimes get that 'ants crawling my face' feeling. My neck and shoulders ache.

I went to see my neurologist again last Monday and after a whopping five minutes he concluded it was trigeminal neuralgia and prescribed me with 200mg Tegretol. I should add that this doctor is eager to prescribe and not so keen on listening.

My question is: has anyone else had similar symptoms to mine? I'm going to get a second opinion from another neuro before going on the Tegretol which is a strong drug but before I do that I want to hear what you guys have to say.

Thanks for listening.

That doesn't sound like Trigeminal Neuralgia to me since it affects far more than the Trigeminal Nerve and the symptoms are so variable. As I understand it, though, Tegretol can help the doctors diagnose TN. If it takes the pain away, it confirms the diagnosis. If it does not work, you wouldn't keep taking it. I would definitely seek a second opinion. Sounds hard to live with. Hope you can find answers and treatment!!

Hi,
Well, if these symptoms are neurological, then taking tegretol couldn't hurt - unless you have a bad reaction to it. If you are unable to tolerate tegretol maybe you could ask for something like neurontin/gabapentin - something that I find personally more tolerable - but it is different for everyone. When I began gabapentin for my face, I was so happy to feel my persistent neck pain (C6/C7 nerve entrapment) disappear.
It's really a crapshoot regarding tolerance of the different drugs, but you might find the magic one that works. Getting a second opinion sounds like great idea - not to mention a third or a fourth, because your symptoms are so generalized, and he only focused on the one. I have no idea what it is, whether it is TN or not, but I do wish you the best of luck on your journey to get to the bottom of this.
Happy holidays,
Lily

Thanks for your replies.

The face and head pain is the latest of my symptoms; I didn't get a firm diagnosis of my other symptoms. One neuro said it could be migraine and another said it was neuropathic pain but didn't offer an underlying cause.

I guess trying out the Tegretol couldn't hurt as it's supposed to help with neuropathic pain as well.

Psychological?
 

Thanks for responding, Lily. Are you perhaps implying that the symptoms could be psychological? I've given this some thought and I know the pain I'm feeling is real. Then again, I've read that psychological issues can trigger physical symptoms. I know that the pain has affected me emotionally and now I'm worried sick that I might get full-blown trigeminal neuralgia down the line (if that's what it is).

Oh gosh Brainedout, no, not at all - I was just more thinking that there are a number of things that it could be, and my comment was more to the effect of that I don't know much about the rest of the body, so I don't know if the symptoms are neurological. Only a doc would. My apologies - the last thing you need is for someone to infer that it is psychological. Been there.
Hugs,
Lily

No need to apologize, Lily, as I myself have thought the same thing. I have no problems seeing a psychiatrist except it would mean more doctors, more expense and possibly even more meds. I need Dr House! :)

Haha - I would even put up with that acerbic personality if he could help me. Can't say that I can maintain niceness myself all of the time. :mad:
Happy official first Monday of 2011!
Lily