HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

What Causes Facial Pain, Nausea And Dizziness With History Of Head Injury?

Posted on Tue, 29 Mar 2016

Question: Hello I had a head injury almost 1 1/2 years ago. I've had Mri , ct, came back negative, but 6 months ago a dti was performed, they said was 2 mm focus of left susceptibility within left parietal lobe subcortical white matter is present. And tiny focus of hemosiderin within the left parietal lobe subcortical white matter compatible within cavernous malformation or Shear injury. Why am I still struggling with daily life. Thank you.

Answered by Dr. Ajay Panwar (45 minutes later)

Brief Answer:
What are your symptoms?

Detailed Answer:
Hi Kbotelh,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

Of course,I shall try to address your concerns at best but please let me know in what sense you are ' struggling with daily life '? In other words,what are your symptoms or medical complaints?
A cavernous malformation, can result in various manifestations like seizures and other focal neurological deficits while a shear injury should not make matters worse now,so long after the injury.Are your symptoms static or have they progressed from past 1 1/2 years?

I shall be looking forward to your follow-up query with details as I asked,so that I can make an impression accordingly.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

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

Follow up: Dr. Ajay Panwar (3 hours later)

Hi thank you for getting back to me. Sorry but I will you in a little more, I'm a fishermen and slipped on deck, it started out as a concussion but went into post concussion because of getting treatment. not quick enough. Have facial pain and sometimes on right side of face swells, leg seems to give out at times. Feels at times that someone is taking a icepic to the side of my head. Nausea, dizziness , at times following conversation can be difficult . I get very tired and seems like laying down is the best. Oh sorry I have been also diagnose with vertigo and inner ear damage. Thank you and sorry for being all over the place.

One of the medicine I take is gaberpentin 1800 mg . Spelling might be wrong

Answered by Dr. Ajay Panwar (18 hours later)

Brief Answer:
Any improvement with Gabapentin?

Detailed Answer:
Hi Kbotelh,
Thanks for being in follow-up and providing further details.

The symptoms do not appear to be specific for any focal lesion, though parietal lesion could be responsible partially for the symptoms,like facial pain.

However,considering the lesion as shear injury due to the history of head injury,nothing active needs to be done and you need to be on antineuralgic medicines as you are on Gabapentin. I need to know whether Gabapentin is improving your symptoms or not?

Simultaneously,multivitamins and antioxidants supplementation may help.

I shall be glad to have you in follow-up.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

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

Follow up: Dr. Ajay Panwar (1 hour later)

I think the gabapentin at times. When my head moves a certain way things just get out of sort. I have pt once a week, and they do soft tissue movements and differnet visual things. After pt the next couple of days are not good, but when they are doing things, it's like my vision clears, it's almost like a rush goes to my head. I've also had two sensory integration balance test done. Eyes open firm surface sway index was.47. Close eyes where .81. Eyes open foam surface swat index .87. Eyes closed foam surface 2.41 and final composite was 1.14. Thank you

Answered by Dr. Ajay Panwar (13 hours later)

Brief Answer:
Continue antineuralgic therapy.

Detailed Answer:
Hi Kbotelh,
Thanks for being in follow-up.

If your symptoms respond to gabapentin,then the drug may be continued else another antineuralgic medicine like amitriptyline may be put on trial therapy.Please discuss regarding the same with your treating neurologist.

Further,if pt provides significant benefit,you may continue the same.

If you have any further questions,I shall be glad to have you in follow-up else please close the thread,rate it and write a review

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Deepak