Thanks for the vote of confidence, Jane -- it has been earned by the entire volunteer staff of moderators and greeters here and in other communities of Ben's Friends.
Basically, I do what I am ABLE to do, acknowledge my imperfect knowledge, and try to be a civil and grounded voice in sometimes desperate situations. Sometimes I see something that is "off" in a physician's reported input, and I'll respond to that. But I'm careful to make clear that I'm not a licensed physician, and to reflect patients back to people who are, for deeper discussion of their concerns and symptoms. I've met some fine doctors in my work with chronic face pain patients -- and I've met some real duds too, about whom my comment has sometimes been "this guy needs his arse kicked into next week." Doctors are no different from the rest of us in that dimension -- and the good ones are honest enough to face that reality and listen carefully to what their patients have to say.
Curtis, I'm not sure that our state of scientific knowledge supports a specific number for the maximum time between an occurrance of physical insult and an outcome of emergent facial pain. From what I've observed in communicating with thousands of chronic face pain patients, there may be reason to suspect a cause and effect relationship, if pain emerges within hours to perhaps as long as six months after dental work, whiplash injury or blunt force trauma. Longer than that, and the connections seem much more tenuous.
On balance, I'd say that the causes of whatever kind of facial neuropathic issue you are dealing with, are simply indeterminant ("idiopathic"). Sometimes we just don't know.
Regards, Red
curtis said:
Mr. Lawhern is there a time frame in which you could say that certain dental procedures or accidents can affect the body?
Besides my terrible accident 19 years ago, I had a whiplash in 2003 (12 years ago) and a wisdom tooth removed in 2009 (6 years ago)
but I never had a single issue until now a week ago.
I told my doctor about the wisdom tooth 6-7 years ago and he said, and he went like nah and then moved on.
Curtis, you asked for an opinion concerning your interaction with a neurologist. On balance, I see a lot of sense in his referral to an ENT. Your symptoms don't track very well with either facial neuropathy or neuralgia. And a blocked sinus can often cause pain that is mistaken for either or both.
That said, I wish he wasn't as negative as he seems to be concerning internet support sites. The Pew Institutes inform us that over 2/3 of Americans check authoritative Internet sites before being seen by a medical doctor for major health issues like diabetes, heart disease, and breast cancer. A lot of doctors tend to be type A personalities who resent patients who argue with them or otherwise don't play the "good patient". So my message to the doctor is that an involved patient is likely to have substantially better outcomes than one who is basically passive, leaving all of the conclusions up to the doctor.
I concur that dentists are badly under-trained on facial neurological issues. I believe that TMJ is vastly over-diagnosed by many of these professionals. We learned a lot about the problems created by poorly trained dentists, in a demographic study I did on 1800 of our members. The study is linked from a sub-tab under the "Face Pain Info" tab, called "Who Gets TN?"
Let us know the outcomes of your consultation with the ENT.
I am calling a foul on the doctor saying viruses do not cause TN. I know people who got them after getting shingles, and one of them never did get the rash, but they did get the nerve pain. Doctor told me the waist, and the face are the two most common places for people to get shingles, but one can get then anywhere. curtis said:
The neurologist told me that all neurological examinations were fine, I asked him about herpes virus perhaps and he said in herpes you would get a rash, (I haven't had such) then pain and plus it is generally accepted that the trigeminal nerve is compromised mostly by vascular compression, not viral infections.
it says that from 15 people who went to the doctor with idiopathic trigeminal neuropathy were followed for 34 months.
from the 15, eight had it go away before 3 months, the other 7 had it chronically and from those 7, only 4 had mild pain, 1 had extreme pain.
amitriptyline was the drug of choice like mr. lawhern told me.
I guess that puts everything into a more clear perspective
I asked him about atypical trigeminal neuralgia and he told me calling a condition atypical is sort of saying "we have no answer" a bit of a wastebasket.
He says the real trigeminal neuralgia has very typical clear and classic symptoms, and patients can most of the time tell where the pain exactly comes from and where it goes, it is excruciating and stabbing pain on one or more of the three nerve branches that last from seconds to minutes, and often have no symptoms between attacks or just a slight burning sensation on the nerve between attacks. perhaps due to prolonged nerve irritation.
He says my case he rather calls it neuropathy which is the proper name for this kind of symptoms.
would you agree with this mr. lawhern?
Richard A. "Red" Lawhern said:
Curtis, we know that the incidence of hemi-facial spasm is somewhat higher in people who also have TN. But for a virus that can devastate "several" of the cranial nerves, there isn't much evidence. The exception might be the Zoster virus associated with Shingles -- but it doesn't target just one nerve or set of nerves. It pretty much goes after nerves all over the body.