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Suggest Treatment For Recurrent Tooth, Head And Eye Pain

Posted on Tue, 4 Apr 2017

Question: Sir, my sister who is about 25years of old is not keeping well since the last 9 years. She used to suffer from stomach pain in class ninth. But as she grew up she suffered from headache and eye irritation frequently. Now she is suffering from toothache accompanied with severe headache and neck pain. We consulted many doctors but no relief . She was diagnosed with sinusitis. Now she is suffering from excruciating pain with toothache and headache in every week. She has also got skinny due to her suffering. Sir please whom to consult. We are really very frustrated about her situation.

Answered by Dr. Seikhoo Bishnoi (6 hours later)

Brief Answer:
Detailed evaluation is needed to make diagnosis

Detailed Answer:
Hello thanks for asking from HCM

I can understand your concern. She is suffering from severe excruciating pain in head along with toothache not relieving with medicines. First of all she should be evaluated properly for the recurrent headache.

Get her CT scan head to rule out any pathology of brain.

Get her complete blood count done. Anaemia should be ruled out. ESR should be checked. This will rule out temporal arteritis.

Her general examination especially focussed on headache should be done. Blood pressure should be checked. Hypertension is an common cause of persistent headache. Intraocular pressure should be checked to rule out the ocular cause.

Once full workup is done then we can rule out possible causes easily. Trigeminal neuralgia could be the reason if her pain is unilateral and is severe associated with pain in face. Migraine is other possible cause.

Please take her to a neuropsychiatrist or neurologist for evaluation.

Thanks and Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (2 days later)

Sir,in 2010 her C.T scan of brain and EEG & BRAIN MAP analysis was done and every thing was recorded normal. But now her pain is (toothache and headache) is increasing. The pain remains for hours and she is trying a cloth or towel around her forehead to get some relax. Sir can you refer something please.

Answered by Dr. Seikhoo Bishnoi (12 hours later)

Brief Answer:
Her symptoms can be treated

Detailed Answer:
Hello again

For some time she can take Naproxen and Domperidone (Naxdom) for relief from pain. All her investigations came normal so there is nothing serious. Most likely reason of her persistent headache is migraine.

Regular use of Amitriptyline or Nortriptyline can help to reduce the symptoms. For episodes of headache drugs like Naxdom can help.

Please talk to a good psychiatrist for her evaluation.

Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (10 hours later)

Sir please prescribe the full course of medication for the use of Amitriptyline /Nortriptyline and the dosages of the medicines along with Naxdom for an adult of 25 years.

Answered by Dr. Seikhoo Bishnoi (10 hours later)

Brief Answer:
Amitriptyline in dose of 10-25 mg will help to control the symptoms.

Detailed Answer:
Hello again

Amitriptyline can be started with 10 mg dose in night after dinner, increase the dose to 25 mg after a week and if needed increase the dose again to 50 mg after 3 weeks. She might have sedation with tablet so give the tablet in evening after dinner only.

Naxdom 250 one tablet daily for at least 2 weeks and then on SOS basis.

Both are prescription medicines and you've to visit a doctor for prescription.

Thanks. Take care

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar