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Asking for Self, Female, 37 years old, Karachi
Hello Doctor, I have been suffering from severe one-sided pain for about one year. Initially, it was on the left side, but now the pain mainly occurs on the right side. The pain comes on its own without any clear trigger. It is not triggered by touching my face, cold air, brushing my teeth, or chewing. In fact, brushing or chewing sometimes gives me relief. The pain is not like a brief electric shock; it becomes very severe, lasts around 1–2 hours, and then gradually settles down. The pain may involve my face, ear, teeth, head, back of the head, neck, and sometimes radiates towards my shoulder. I have already consulted different doctors for this problem. Today, an ENT specialist diagnosed Trigeminal Neuralgia and prescribed Tegral (Carbamazepine) 200 mg at night. Could you please advise whether my symptoms are consistent with Trigeminal Neuralgia? Since the pain changed from the left side to the right side and lasts for 1–2 hours, would you recommend an MRI brain/trigeminal nerve imaging or any other tests to confirm the diagnosis and rule out other causes? Thank you.
No MRI needed make a headache diary and consult
Obviously you are not happy with the diagnosis made by the ENT specialist. Your symptoms may or may not be consistent with Trigeminal Neuralgia. However the differential diagnosis includes cluster headaches or migraine. Did carbamazepine help?
Consult a Neurologist in person to see if its really TGN so you could have treatment options
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