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intractable facial pain, complex case

Ear, Nose & Throat (ENT) | Last Active: Jul 2, 2023 | Replies (22)

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@nrd1

@carterbeauford

And into adulthood were you ever on any regular topical allergy regimen?

I’m sure you’ve had all the questions.
Allergic Rhinitis/Non Allergic Rhinitis/Migraine type symptoms all can overlap as much has to do with high histamine levels and increased nerve sensitivities.

I believe there is help out there for your pain and chasing pain at the source is very tough.

I know nasal/sinus surgeries can help a small % of people who check all the right categories.

However the things that caused allergies sensitivity as well as non allergic will still be there.

There are many people whom suffer through the first change in winter season post surgery due to their sinuses being more open. They tell you your brain will just have to get used to the changes.

But when allergic/non allergic/migraine type sensitivities are in play, that type does not like changes to the already activated nervous system.

It’s way too deep and complex.
But it all plays into one.

Which is why I do not agree with nasal/sinus procedures for each and every patient (it has to selective).

I’m sure you’ve also been offered an SSRI at this point as at a low dose they work on the pain pathway. Dopamine, Norepinephrine,Seratonin. It’s all just really complex.

This might be very multifactorial for you at this point. So I recommend working at it through multiple channels as it might not just be one source. But I’m sure you have been told that already.

Good luck to you in your search with this.

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Replies to "@carterbeauford And into adulthood were you ever on any regular topical allergy regimen? I’m sure you’ve..."

Stopped allergy shots around age 20. Briefly tried them after second sinus surgery before I realized I have a traumatic peripheral trigeminal nerve injury.

Amitriptyline was ineffective along with every other trigeminal neuralgia and migraine medication.

Multifactorial, yes, after 60 doctors I have exhausted the list of treatment options and feel an implanted spinal cord stimulator would give me some quality of life.