Atypical facial pain - atypical ondolgia

I have vague diagnosis of atypical facial pain…pretty sure its Atypical Trigeminal Neuralgia. I get that constant pain that feels like tooth ache and it ain’t and tender cheek on same side. I wrong thought oral maxifacial team would decide on drug treatments but wrong that is pain clinics domain. I am wondering for this type of pain whether gabapentin, trilepital or tegretol is best?

First med in USA for ATN is trileptal. I was actually told if there was no reduction in pain after the first dose it probably wasn’t ATN. You may not get complete relief but you should feel something.

Then there are a host of other meds with good track record with TN/ATN. Tegretol. Lamictal. Amitriptyline. In some cases gabapentin or lyrica but both of those have lesser success and despite what you may be told are not actually tested or approved for TN/ATN.

Go low and slow with all doses of all meds is my advice. In the USA there is trend to dose TN/ATN the same as fibromyalgia, which makes little sense as they are not the same, lower doses tend to work on TN/ATN so proceed with care.

I have different diagnosis’s from trigeminal nueropathy, atypical facial pain, TN 2 and TMJ. I have been on gabapentin , nortriptyline, with baclofen and clonazepam. The nortriptyline is the only thing That worked for me but I had to get off it because of another med I need for something else that does not go well together. Nortrptyline also does not go well with a lot of other meds and over the counter products. However, if it is the only med that helps you I would say to use it because you need to get pain relief and every med has side effects. I am now on Lyrica 300 mg a day and waiting to see if it helps. I don’t know how to start my own discussions on here so I am hoping to get some help through this discussion. Has anyone ever tried a sphenopalatine ganglion block? My pain doc recommended this but I have never seen anyone mention this. I also would like some advice determining whether a lot of my problem could be from TMJ. In the past 2 months I notice that talking brings on my pain and it is getting to the point that as soon as I start talking in the morning in causes pain in the tooth area and it doesn’t ease up all day. Does anyone have this issue. Also, I would appreciate it if someone can tell me how to start my own discussions. Thank you for any help you can give me and I hope everyone had a pain free day.