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trigeminal nerve injury or muscle injury

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Old 06-12-2015, 11:31 PM   #1
blizzard
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Default trigeminal nerve injury or muscle injury

Hello everyone,

I have been following this group for a while and I finally gathered the courage to post myself. I am a female, 26 years old, living in Montreal, Canada. During the past 4 and a half weeks my life has been hell. I am in constant pain and so scared. I apologize for the long post, but I don't know what to do. I really need some help I don't know what is wrong with me...Is it nerve damage, muscle damage, allergy or something else? Thank you so much! Here it goes. I tried to organize it as best as I could...

History (before the horrible pain):
Clenching and grinding teeth especially at night, limited jaw movement, difficulty chewing hard food; Very sensitive teeth. These symptoms mostly affected the right side of my face. I also recently found out that I am allergic to a topical dental anesthetic (i think it was benzocaine).

Beginning of symptoms:
On May 13th this year I had a root canal retreatment done on the right lower molar. There was no pain in the molar before, just some slight sensitivity. The dental injection was very painful, but there was no electric-shock type pain. The area was very sore and swollen after the procedure and I had a few hours of burning on my chin and lower lip. I was taking iboprufen, clindomycin, and atasol codeine and the pain began to improve gradually. One week after the root canal, I went to my general dentist to have a permanent filling done. The root canalled tooth was painful and the dentist refused to do a permanent filling but instead insisted that he does a filling on an upper molar on the same side (he kind of forced me so that the appointment is not lost). When he injected me with the anesthetic, I felt an electric shock that radiated from the injection site along the cheek bone up to my ear. The pain subsided in less than a second so I did not think much of it. When he finished the procedure, I noticed that my entire right upper jaw and face were extremely numb and my right face was in a weird contortion, like a scary grimace. When the anesthetic wore off, I had the most excruciating pain in my life. The upper right molar was throbbing as if I had pulpitis. The pain was jumping from tooth to tooth and going back to the upper right molar. My right cheek was also throbbing and in horrendous, piercing pain. The pain was so strong that at some point my upper cheek went into a painful spasm. I also felt debilitating pressure in the area under my eye. Codeine helped the pain but the severe pressure remained. I went to see the dentist and he said I had a hematoma and the pain should subside within a week. He was wrong...
The throbbing in the upper molar subsided but occasionally returns
There is a point in my cheek, right under the eye, under the bone (where the electric pain during the injection originated) that when pressed lightly leads to the return of the piercing pain and burning in the area that lasts hours.
Muscles on the right side of the face feel very sore and painful all the time and my jaw is locked; When I move my face or try to chew or smile I get painful muscle spasms in the right side of the face (upper and lower jaw). My muscles on the neck, head, right shoulder and right arm are also painful.
I have burning on the lower and upper lip that was initially intermittent, and then, became almost constant. When I talk, smile or touch the lower lip or the front lower teeth, the burning turns into a painful piercing pain in the lower lip and occasionally the burning spreads to the area under the nose and the cheek. My front lower teeth also begin to hurt a lot during such episodes.
Things that make pain better.
Not talking or moving the face (almost no pain when I wake up); Right now I am afraid to talk...
Cold and hot compresses or food
Stretching, and massaging the neck, and shoulder, and area above and in front of the ear


Things that make the pain worse:
Touching the lower lip
Chewing, talking, pressing on the point under the eye, some neck movements

The pain fluctuates between less and more severe, usually no symptoms in the morning and severe pain at the end of the day or when I move my face... Over time, however, the pain increases and more regions get involved....

I am so scared that it will continue getting worse. The dentists and endodontists claim it is not tooth-related... I tried iboprufen and steroids (prednisone), reactine, benadryl, tylenol, atasol codeine, clindomycin, and penciline with limited improvement... Usually the medication that have muscle relaxing effects have the greatest benefit...One doctor prescribed me Trileptal for 6 months but I am too afraid to take it... I was just wondering if my symptoms sound to you like trigeminal neuralgia (maybe atypical) or something else. Should I take the medication or wait and hope that it will improve? Do you have an idea what it could be or what I should do next. Thank you so much!
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EnglishDave (06-13-2015)
Old 06-13-2015, 07:39 AM   #2
EnglishDave
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Hi Blizzard,

So sorry you are having this trouble, any neurological facial pain is debilitating and miserable.

My initial suggestion is to copy your Post over to our Dental Forum for Bryanna to give you an unbiased opinion, in my opinion you seem to have a lot going on there, and everything has a trigger.

As to your symptoms, have you seen a Neuro? I would classify the pain the same as my constant pain/paresthesia - Atypical Neuropathic Facial Pain - which covers them and covers all bases. TN is fleeting, electric shock, stabbing pain, but that does not rule out damage to your Trigeminal Nerve, I am in the unfortunate situation where my damage causes both.

As for ongoing treatment, for Neurological issues you are not going to get any relief from conventional pain killers, that's why you have been rxed Trileptal, which is an anti convulsant/anti epileptic. I have to take Topiramate (same type) for chronic Cluster Headaches, and it has the bonus of dulling my pain and TN a fair amount. I noticed by how much earlier this year when I had to increase dose and got a pleasant reduction of pain in my face due to this side effect. My advice is do not be scared of a med that could potentially help you greatly, just watch the negative side effects like low sodium.

I truly hope you get this issue resolved as quickly as possible, you did the right thing in joining us. If nothing else, we understand what you are going through.

Dave.
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Old 06-13-2015, 07:55 PM   #3
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I also wonder if this is, at least partially, a dental problem.
Some possibility of a TMJ issue.
However, it might very well be BOTH a dental AND a neurological problem.
Perhaps your nerve was damaged during your treatment. (This is basically what happened to me. )
Even if you have a dental problem, this doesn't mean that if it is corrected, you will be alright, if you ALSO have nerve involvement / damage.
A med like Trileptal might help nerve damage. However, I think what is more well known to be of help are the meds Elavil and/or Gabapentin. I definitely would consider taking any of these meds, because if you have nerve involvement, it takes a med like Trileptal or one of the others to make a dent in it. Sometimes high dosages are needed or more than one med. BACLOFEN might be a great secondary med for you. I use it sometimes. It is technically a muscle relaxer, but seems to work unusually well for folks with nerve problems...I think some call it a muscle relaxer with some anti seizure type properties (don't know if that is technically accurate, but it is the only muscle relaxer that helps my bad facial neuralgia that started after dental work).
Sometimes if the nerve is involved it can cause temporary pain, LONG term pain or permanent pain. The pain is almost always VERY bad.
Does heat help at all!? A heating pad on your right side?
Wishing you relief and SOON! Find a great doctor or doctors. You might have to get a second opinion...but don't give up hope!!!
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EnglishDave (06-14-2015)
Old 06-14-2015, 11:13 PM   #4
blizzard
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Dear Dave and Vowel Lady,
Thank you so much for your replies! The positive energy I find in this group is helping me immensly! I am very sorry you have to go through so much pain too! It's been about a month for me and I can barely remember what it is to be pain-free and enjoy life. I hope to get an appointment with a second orofacial specialist next week. I will ask her about the meds you mentioned and see if she also wants me on Trileptal. If she confirms the prescription, I will have to take it... Hopefully, seeing the specialist will shed some light on the cause of this horrible state. She is a dentist as well, so I will ask about the possibility of a dental problem. I will copy my post to the dental forum but also keep posting updates here. I hope that I will find a solution that someone with similar problem might find helpful. I hope both of you feel better soon!
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Old 07-09-2017, 08:01 PM   #5
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Quote:
Originally Posted by blizzard View Post
Dear Dave and Vowel Lady,
Thank you so much for your replies! The positive energy I find in this group is helping me immensly! I am very sorry you have to go through so much pain too! It's been about a month for me and I can barely remember what it is to be pain-free and enjoy life. I hope to get an appointment with a second orofacial specialist next week. I will ask her about the meds you mentioned and see if she also wants me on Trileptal. If she confirms the prescription, I will have to take it... Hopefully, seeing the specialist will shed some light on the cause of this horrible state. She is a dentist as well, so I will ask about the possibility of a dental problem. I will copy my post to the dental forum but also keep posting updates here. I hope that I will find a solution that someone with similar problem might find helpful. I hope both of you feel better soon!

Hey Blizzard,

Any luck with your pain?? pl respond me..
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Old 07-26-2017, 11:26 AM   #6
patmccplumbing
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Default my cure for Trigeminal Neuralgia

I hope you not in pain anymore but if you are I have had great success in a drug called Gabapentin I now take 800 mg x3 daily with my tegretol x2 daily it has changed my life drastically I'm now back to work Please try
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Old 09-08-2017, 11:33 AM   #7
gabeljust4u
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Default Glad those meds are helping you

Quote:
Originally Posted by aslam25m View Post
Hey Blizzard,

Any luck with your pain?? pl respond me..
Hello; this is my first post since I just joined the site. I'm dealing with my second bout of trigeminal neuralgia since my diagnosis in 2006 in spite of 2 gamma knife procedures and brain surgery. So far, no meds have stopped or even reduced my pain. In fact the left side of my face is numb since the brain surgery; but the pain has recurred in a different place on that side of my face. I am currently seeing a neurosurgeon at the Mayo Clinic who has recommended two different procedures to eliminate my pain or at least cut it in half. Is there anyone out there who has experienced this sort of thing? It's very frustrating to live in chronic pain for this long with no relief with meds or the surgeries. I'm do happy for people who are helped with medications.
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