Trigeminal, but not Trigeminal Neuralgia. What is it? HELP

Posted by fdouglass @fdouglass, Jul 5, 2023

I came down with a virus mid December that would not go away. 5 rounds of antibiotics later and a CT-scan, I got into a ENT. He told me that my sinuses looked great and I had no sinus problems, but that it was my trigeminal nerve. I had sinus pressure behind the eyes, pain, mucus, and I felt like my eyeballs were being pushed out of my head. ENT referred me back to my PCP and said for her to put me on Carbamazepine. The carbamazepine worked on 50% of my issue. Then a MRI and an appointment with my neurologist. She said it was just migraines and nothing to do with my trigeminal. She put me on nortriptyline and said to start weening off the carbamazepine after 30 days. While I was on both, all was great. I felt like I had my life back. A week after I hade weened off of the carbamazepine all the sinus symptoms came back. So I called and she put me back on the carbamazepine. It has been a month since I have been back taking both. I started to feel better and then, AGAIN, I am having sinus pressure behind my eyes, pain, mucus, and bad headaches day and night. Every time it feels like the flu, but the flu goes away.

Has anyone been diagnosed with anything like this and told it is an overactive trigeminal nerve?

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Over the last 15 yrs. I experienced pain in my teeth on upper left side of my face. The dentist called it my phantom tooth pain and she couldn't explain it. I had a tooth removed and an implant, but the pain didn't go away. at times the pain felt like an electrical shock, at other times sinus pressure or throbbing. It would come and go, sometimes lasting a few hours, days or weeks. I was sent to 2 endodontists, but my teeth were fine. One recommended I see an ENT. She said my sinuses were impeccable and suspected Trigeminal Neuralgia. I was started on 100 mg of gabapentin 2x daily and it didn't help. I was then put on 300 mg of oxi- carbamazepine but it made me dizzy and nauseated. My primary doctor started me on 100 mg of pregabalin 2x daily and sent me to a neurologist. MRI with and without contrast of the brain did not show any problems. The doctor told me that oxi- carbmazepine is the suggested drug and that I was started on too high of a dose. He told me to stop the pregabalin to see how I do. I stopped it and experienced a severe headache for as long as I was off the drug. Once I started back my headache went away. Has anyone else experienced, severe headaches? I also have sinus pressure and there are times when my nose will just run and not stop. Unfortunately, doctors don't know much about TN or what to do about it. There are very few neurologists that specialize in TN. Thank you all for sharing your stories.

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@wander3314

I was born in 1948 and have had TN 1 twice. All the medications made me tired and dizzy. I'm afraid of falling.
After six years TN came back. I was able to reduce the number of shocks to 1 a day and then if I was extremely careful to no shocks in eight days. TN went away and hasn't come back.

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As an aside the trigeminal nerve can be aggravated by CPAP straps and poor fitting eye glasses or anything that puts pressure on the trigeminal nerve around your ear.

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@fdouglass

I completely understand. I had a great PCP that was genuinely trying to help. Then she took another position as an er doctor. All the other doctors either pass the buck and send me to another specialist saying it is not something they treat or say "oh, it is just migraines". It for sure causes migraines rains. But, it is not just migraines. How do you find a doctor that deals with crazy sinus issues not caused by your sinuses. I hope you find your answers soon.
Thanks @johnspirit2

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There is a Mayo Clinic doctor at the Jacksonville, FL location who writes he is "interested" in hemicrania continua. That doctor is Dr. T. Rozen. I've never seen him. Do you know the Latin expression sin qua non? That means "without which, not." So, the confirmation for hemicrania continua (HC) is if your headaches are helped by indomethacin, that means you have HC. And if I apply the sin qua non correctly: without help by indomethacin, then you do not have HC. Writing here because I also heard "oh, it is just migraines"--that anyone would dismiss migraines with "just migraines" is uncaring/unknowing. Migraines hurt. HC hurts a lot and is continuous. Many doctors do not yet know about it. Read up on it so you can help yourself. I've had headaches for decades, *maybe* both migraines and HC--how to separate types of head pains? Indomethacin has helped me. As with most drugs there are side effects. Start reading and help yourself and your doctors. I showed up to a neurologist appointment with a printout of a medical paper I found on the internet. For HC, look for Dr. S. Prakash in India. I found his paper, perhaps 4 years ago, it matched my symptoms. I also have chronic nasal congestion, by the way.

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