I used to suffer from vestibular issues (vestibular neuritis) which has pretty much resolved but briefly after I developed this neuropathic type pain mostly on my second TN branch
Reading your valuable posts I found that you mention in one of them that there is no evidence of herpes (which can cause vestibular neuritis) causing TN or ATN... you also told me that is it is unlikely that the herpes virus can go from cranial nerve to cranial nerve affecting them one by one, you do mention however that herpes can cause post-herpetic neuralgia which is different from actual trigeminal neuralgia or atypical TN.
I had an MRI which looked at the trigeminal nerves with contrast (fiesta) and showed no nerve blockage or issue, it was completely normal but showed a maxillary sinus blockage which seem to have been there for quite some time (chronic)
my neurologist discharged me and assured me I don't have TN or ATN or any neurological issues and referred me to an ENT which I am waiting to see.
my question is.... what can I do as far as making sure that the sensations I feel are not neuropathic? is there any test?
Its been five weeks of this facial issue and so far I have no rashes that look like shingles, plus shingles don't last this long am I right?
thanks so much for any input you can give me
Curtis!
Okay, so let's refine the discussion just a tad. The virus which causes post herpetic neuralgia is Herpes Zoster. It lies dormant in the nervous system sometimes for years after a case of chicken pox. When it emerges (for reasons I don't believe medical science yet understands) it produces widespread nerve pain at various points in the body, and usually a raised rash, often for weeks to months. Pain "just" in the face with Zoster is unusual, and pain in the face without rash is even more unusual. Pain only in the face, that persists without rash for five weeks is almost certainly not Shingles.
Herpes Simplex I on the other hand is the virus that causes cold sores. It's common, and there is some speculation in medical literature that it may cause inflammation in cranial nerves if the virus gains access through the blood-brain barrier. While there is speculation, there is as yet no consistent proof of a mechanism for inflammation from this source.
Regarding tests to confirm ATN, probably one of the best would be a positive response and reduction of pain when you are tried for several weeks on one of the tri-cyclic anti-depressant meds like Amitriptyline or Nortriptyline. They are consistently helpful for large numbers of people who deal with facial neuropathy, which is basically what ATN is.
In your case, another step that might make sense is direct delivery of an antibiotic into the maxilliary sinus, to clear up the blockage you mention. Oral antibiotics aren't always effective in sinus infections. However, an ENT is an appropriate physician with whom to discuss such steps and distinctions. I advise you to do so.
Regards and best
Red