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What Causes Extreme Left Sided Face And Head Pain?

Posted on Fri, 27 Feb 2015

Question: I have been experiencing extreme left sided face and head pain mainly around my temple. Its a pounding / throbbing pain for over 8 weeks. Doctors have tried botox injections , Home oxygen, Dilantin and Indomethacin with no luck. I am going insane with this pain and now having panic attacks. dr are thinking Trigeminal Neuralgia but 2 months of treatment have been useless

Answered by Dr. Het Ram Bishnoi (4 hours later)

Brief Answer:
Trigeminal neuralgia can be treated with medicines

Detailed Answer:
Hello welcome to HEALTH CARE MAGIC

Pain on one side of face along with involvement of temple can occur due to some neuropathic condition. As common treatment methods along with botox injections haven't resulted in improvement so this need further evaluation. Trigeminal neuralgia (TN) is a pain condition which is characterised by severe intense pain in distribution of trigeminal nerve. The pain involves temple area to cheek area (buccal area). But the pain usually occur in episodes and doesn't remain persistent. If the pain is very severe and is occurring in episodes then most likely its due to Trigeminal Neuralgia.

No specific diagnostic test is available for TN but proper clinical evaluation is needed to make diagnosis. I will advise you to consult a neurologist for treatment and evaluation.

Most of patients suffering from TN respond to medicinal treatment. Carbamazepine, Oxcarbazepine are commonly used medicines for TN. Most of individuals show reduction in pain with these medicines. Analgesics medicines like Codeine also have good results. Consult your doctor for prescription of these drugs. Please don't panic, the pain will be controlled with proper medicines. Avoid cold wind in face area as this may aggravate the condition.

Thank-you.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Het Ram Bishnoi (16 hours later)

I have used the medications you mentioned along with Dilantin and home oxygen treatments.. the pain is constant 24/7 and nothing gives me even minor pain relief. I have been experiencing panic attacks due to the constant throbbing pain. I have been seen by primary care and 2 neurologists. I CAN NOT TAKE THIS PAIN ANYMORE

Answered by Dr. Het Ram Bishnoi (25 minutes later)

Brief Answer:
For persisting pain Opioids can prove useful

Detailed Answer:
Thanks for asking a follow up

If pain is persisting even with these medicines then best option is to take some pain relief medicines on SOS basis for some time and then consult a neurologist. As botox injections also failed so last option is surgery. In surgery pain fibres are ablated and this result in significant improvement. For pain medicines like Pregabalin and Codein (Opioid) can be used. These medicines will result in significant relief. Visit your neurologist for prescription.

Thanks

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Het Ram Bishnoi (1 hour later)

Thank You. I currently take 32 MGs daily of Subutex. I was placed on Subutex when I was detoxed off of Morphine in 2010 . I was taking Morphine to control pain from a work injury in 2005. None of my doctors are willing to prescribe any kind of narcotic pain medicine while I am taking Subutex. I have been trying for over a year to detox from Subutex without much luck. Do you know of any Neurologist is the New XXXXXXX CT area..I have already been seen by 2 without much luck. They are baffeled as the cause of the pain. In the last 6 months I received over 100 botox injections without any pain relief. I was even examined for Giant Cell Arthritis.

Answered by Dr. Het Ram Bishnoi (22 minutes later)

Brief Answer:
Continue to take pain medicines till you see a neurologist

Detailed Answer:
Thanks for asking a follow up

Continue to take Subutex till you see a neurologist. I am really sorry but I am not aware of any reputed neurologist in New XXXXXXX CT area. Consult your existing neurologist about surgical management of pain.

Thanks, wish you a good health

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Het Ram Bishnoi (51 minutes later)

Thank you very much. This is the most painful thing I have ever experienced and my medical history is very extensive. I am in a near panic mode all day and at 65 years old I fear of having a stroke or worse do to the stress of this constant pain. Living alone makes matters worse. Even a trip to my local ER at XXXXXXX New XXXXXXX Hospital had me leaving there without any definable answers as to the cause. A CT scan and Ultra Sound did not reveal anything. They did give me 20MGs of Valium to calm my nerves but it did nothing for the pain. They also gave me Gababentin ( neurotin ) without any luck. Thank you for trying to help me.

Answered by Dr. Het Ram Bishnoi (21 minutes later)

Brief Answer:
Don't be distressed the pain will subside in some days

Detailed Answer:
Hello, thanks for writing again

Don't fear of having stroke due to anxiety. The severe anxiety and panic are getting precipitated due to pain and relief of pain would result in improvement. It is really difficult to manage pain of Trigeminal Neuralgia but the pain would subside in some days. I will request to not to loose patience and don't be distressed.

For anxiety continue to take the Valium doses as prescribed and see your doctor again. Combination of Pregabalin, nortryptiline can also help apart from the medicines I have mentioned earlier. Visit your doctor asap.

Thanks

Above answer was peer-reviewed by : Dr. Ashwin Bhandari