Talk to Neuro Physician on TRIGEMINAL NEURALGIA

Patient History: 4-month history of severe right lower gum pain. Initial dental exam and X-rays were normal. Neurological brain/facial MRI was clear. Tegretol (400mg BID) successfully relieved the sharp pain, yet persistent gum swelling and an inability to chew on that side remain, significantly impacting his quality of life. Behavioral Context: Over the last three years, there has been a concerning shift in temperament. He exhibits extreme irritability, hyper-reactivity, and harsh language toward family. He demonstrates significant difficulty taking accountability, irrational jealousy, and negative thought patterns. Episodes often escalate to threats of divorce, followed by prolonged social withdrawal (self-isolation for up to a week). Given his family history of psychological issues, these patterns are deeply concerning.