Talk to Neuro Physician on Neurological
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.
Dr. Hashir Amin Malik - Neurologist
MBBS, MD Neurology | Lahore
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?
Patient
Post Owner
I only took carbamazepine (Tegral) for a short time, and unfortunately I had significant dizziness after taking it, so my doctor discontinued it. Therefore, I could not continue it long enough to determine whether it was helping my pain.
My pain usually comes spontaneously, becomes very severe, lasts around 1–2 hours, and then gradually settles. It does not usually have typical triggers such as touching the face, chewing, brushing, or cold air. Could you please advise whether this pattern is more suggestive of migraine, cluster headache, or another type of headache rather than Trigeminal Neuralgia?
1 month ago
Patient
Post Owner
I would also like to mention that I recently consulted a neurologist. He suggested an MRI brain/brain screening and prescribed Frendol-P, Renerv, and Carlep. He also discontinued the previous medicines. I would appreciate your opinion on whether I should proceed with the MRI and whether these medicines are appropriate for my symptoms.
1 month ago
Patient
Post Owner
Also, my dizziness started after I started taking Tegral and the other medicines prescribed by the ENT. Even after stopping those medicines and starting the new medicines, I am still experiencing dizziness. It has not completely resolved yet.
1 month ago
Dr. Mirza Naushad Baig - Neurologist
MBBS, Diploma in Neurology (Vienna, Austria) | Karachi
269 Positive Reviews
Consult a Neurologist in person to see if its really TGN so you could have treatment options
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