My Geniculate Neuralgia Story Starting w/Shingles & a TN diagnosis


My name is Laurel aka shinglesdidit...

I have Geniculate Neuralgia (GN) stemming from Post Herpetic Neuralgia from a bad case of the shingles back in 2010.

The illness started with the worst earache I've ever had, three days later I came down with a rash. Interesting part of all of this is that my rash was on my left thigh. Nothing on my face or in my ear! When I went to the hospital I was just positive that the ER docs would find shingles there as well, but there was nothing, not even redness. It took me 18 months to get a referral to an ENT who diagnosed me with PHN. Then I had to convince my NP to refer me to a neurologist which took me another couple of months. My NP diagnosed me with 'Somatization disorder' during all of this...she promptly dropped that diagnosis once I saw the Neuro and he confirmed PHN and also suggested that I might have a rare disorder called 'Geniculate Neuralgia'. This neuro promptly retired and again I was at the mercy of my suspicious NP. Finally got a neuro an hour away that first diagnosed me with Trigeminal Neuralgia. I was enrolled in Pain Management and promptly got a nerve block (real bad experience) It did nothing. Back to my neuro for upped meds ie. cymbalta, tegretol, neurontin, norco, but with poor results. At one of these appts. I asked him to review the notes from my previous neuro as I remembered he spoke of a rare condition he thought I could have. Upon review of those notes my neuro changed my diagnosis and set me up to confer with a neurosurgeon to see what those options might be.

I met with the NS, he reviewed my MRI and then after talking to me he made the clinical diagnosis of GN and offered me a look at Gamma Knife surgery. I researched it with family and then made the appointment to meet again with that NS and his partner w/Gamma Knife, a radiology oncologist. At this meeting both doctors were graphic with the possible side effects, I think trying to scare me but I was in so much pain at the time (on purpose did not take med) that they a l m o s t scheduled me. The whole PHN caused GN was the deal breaker. They told me that they knew of only 15 cases (me 16?) worldwide of my particularly rare case. That being that I actually had shingles on the nerve in my brain as well as on my skin/limb on the same side but no where near each other.

I left in tears of course and figured I was going to been on narcotics the rest of my life...which was already taking a toll on my other systems.

I came home desperate for some help or support with all this because even though my family validates me, rare conditions are hard to swallow, even for me.

I had a death wish by this time but God wasn't biting and I couldn't tell the ones I love and live with( 9 of us together) about the way I was feeling. God brought me to BensFriends I believe and within a couple of days I was lead to the DOCTORS tab and searched out Gamma Knife NS's in my state and by golly, I got hits! I researched the hits and chose one and wrote to her via the email she provided and gave her the details of my GN and it being PHN but without herpes on or by the outer ear. She wrote back within two hours and told me "Yes, I can help you! Call for an appointment." I couldn't believe it! I gave the family a quick survey and they agreed it couldn't hurt to see her. I got an appt for 5 days later. Her team put me through the works with new MRIs etc, checked my eyes and nose....bunches of tests over 2 days. The proof was in the different types of MRI's they did as they could see scars on the geniculate nerve. Hallelujah!

From there I saw 'her' radiology oncologist who confirmed diagnosis and told me he was on board with giving GK a try for my GN but reminded me how rare all this was and that it could take upwards of 6 months sometimes for the radiation to do it's thing. I have to admit my stomach dropped right then as I really wanted to wake up cured somewhat or a little.

I had my GK surgery April of 2013 and after 6 months of no change in my pain (feels like stabs to the eardrum 24/7) they have deemed it unsuccessful. I want to say here that not one neuro that I've seen for this has ever mentioned Ramsey Hunt. I wonder if that's because I didn't have any herpes in the ear? Anyway... In Oct/2013 I began P-Stim treatments that consist of 3 acupuncture tacks poked into nerve paths on my outer ear, to leads attached to a battery pack. When all are glued/taped/attached/switched on, I receive bee sting like shocks randomly over the next 72/84 hours. The thinking behind these treatments is to produce endorphin rushes similar to the ones we get with our GN pain, and to train the brain not to react to that pain stimuli. It has worked very well with her TN patients.

I presently have # 5 attached. I have had different side effects with each implant. They have switched ears as the nerve paths/blood flows are the same on each ear but it hasn't seemed to matter. I've had the pain exacerbated by these, get vertigo to the point of vomiting, headaches/migraines, and it interrupts my already crummy sleep pattern by stinging me randomly throughout the night.

We talked this time about how much longer we're going to do these treatments as I can have up to 15 but why, when they're not working. We've decided to keep these up until April and then talk to our RO about possibly doing another GK surgery and this time upping the radiationdose slightly as the first time they gave me a dose 20% less than they give the TN patients.

I'm hoping that he'll agree to give it another try. The risks go up and I've been very fortunate not to have had any from the first try at GK. They are still very nervous about the whole PHN and fear there could be other scars that the MRIs don't see thus possibly fixing only part of the problem...that would suck! But I would take any reduction in pain....this has gone on for too long and all the medications that I've been taking for this and for other diseases I have, are causing other health issues and I don't want nor can I handle, any more health issues! Know what I mean? I'm in line for psychotherapy and my number could not come up soon enough!

Thanks so much for taking the time here. I appreciate any and all feedback and I would love to hash things over with anyone!

PeacenLove~Always~Laurel aka shinglesdidit

They can’t find the reason behind my gn…no vascular nerve involvement,son mri, so I’m back to square one, ending up in the er every two weeks, with attacks in between. Feels like a bad earache with excruciating stabs in my eardrums…the er treats me like I’m crazy. My primary told me to put cotton in it during attacks…no way can I touch my inner ear. I’m on tegrtol and topamax…don’t know how long I can take those. Any ideas…help, anyone!

Laurel, I wish you well with whatever treatment you have. I have you in my thoughts.

Poor thing. Mine is quite rare being caused by shingles...you haven't had shingles have you? Mine feels the same as yours 24/7
. You need a neurologist and then a neurosurgeon...they are the ones who have seen this before but I must warn you...Geniculate Neuralgia is a really hard one to fix...I do have pain control by meds but I don't want to be on them forever....I have to keep trying to rid myself of this. Check the doctors tab for neuros in your area. Will be keeping you in my thoughts. Be sweet to yourself!

PeacenLove~Always~Laurel
weirddiagnosis2013 said:

They can't find the reason behind my gn...no vascular nerve involvement,son mri, so I'm back to square one, ending up in the er every two weeks, with attacks in between. Feels like a bad earache with excruciating stabs in my eardrums...the er treats me like I'm crazy. My primary told me to put cotton in it during attacks...no way can I touch my inner ear. I'm on tegrtol and topamax...don't know how long I can take those. Any ideas...help, anyone!

Laurel

I can relate to your story in so many ways :). Death wish, to incorrect diagnosis', to so many meds, horrible nerve block experience for the last 2 years.

I too started off with the worst earache I've ever had in my life. I told everyone it was like a screw driver in my ear 24/7 and all the doctors kept trying to treat the "hematoma" or large purple polyp in my ear with ANTIBIOTICS for months. I had nerve damage hearing loss, nystagmus, nausea, low grade fever, swollen glands, and pin size red dots all over the body. The 5 ENT's I saw never put or thought to test me for shingles. Just recently a Godly friend of mine came across literature online that may have found the reason for my pain-Post Herpetic Neuraliga. After my Mastoidectomy in 2012 to remove the blood clot in my ear and now that the pain has traveled to the nerves in my face, eye and arm, I am trying to get into an infectious disease doctor.

Sorry, I know we have a discussion on another page, but this was a more concise way on giving you my background and hope it makes more sense. I'm just so frustrated and don't quite understand how a doctor is not connecting the dots. It is so utterly frustrating that they keep wanting to give me pills to treat the symptoms rather than help me find the cause.

Thanks so much for opening up and sharing your struggle. I would love to hear more about your tests and how you got doctors to listen to you. I hope you are well and feeling better and your treatments are helping you! Please keep us posted :) Take care!!

Something that has worked for me for many years, as far as earaches are concerned, is to pour a few drops of hydrogen peroxide in my ear and let it boil for about 15 minutes, then flush it out.

DR.J

Sweetie, I think you should ask your primary for a referral to a neurologist/neurosurgeon as soon as possible. Your's sounds like geniculate neuralgia and it can be caused by various things. There is also a printout circulating around here that tells ER doctors about your pain...sometimes we can't even talk when we're having attacks....with this printout you just have whomever takes you to ER, hand it to your ER Doctor along with your med list and General Physicians info. When I went in for my shingles initially, I was having more pain in my ear than where the rash was. They told me sadly that there was nothing going on in the ear that they could see...but they did document my complaint so that when I did finally see a NS that would listen, that info was there for them to read...not just me telling them from my own memory.

Don't stop your search for a neurologist/neurosurgeon. They are the ones that have any chance of helping us. Use the Doctors Tab and look for ones in your state/area and write to them. You'll be able to weed out the not so experienced in this disease from the ones who can actually help you by communicating with them prior to an appointment. Good luck with this. I want to hear what you come up with so please accept my friendship so I can follow your case.

Thanks for stopping by and taking the time.

PeacenLove

Always~Laurel

weirddiagnosis2013 said:

They can't find the reason behind my gn...no vascular nerve involvement,son mri, so I'm back to square one, ending up in the er every two weeks, with attacks in between. Feels like a bad earache with excruciating stabs in my eardrums...the er treats me like I'm crazy. My primary told me to put cotton in it during attacks...no way can I touch my inner ear. I'm on tegrtol and topamax...don't know how long I can take those. Any ideas...help, anyone!

Check out Dr. Walter Crooks in Houston, TX

http://noneuropathyhouston.com/

Excellent information.

DR. J

Yep, it sounds to me like they missed the shingles on you. Now I think you'll just have to be persistent with your GP and get referrals to neuros that have dealt with PHN.. I have no pain associated with my actual ear. I can pull, tug, stick my finger in it...none of these cause me pain. The pain is from the nerve inside the brain directly beyond the eardrum...the ear itself does not hurt at all. This is how they made the clinical diagnosis...from my definition of the pain. Then when they did specialized MRI's...that's when they found the scarring on the nerve. For whatever reason, when I have attacks I can push my finger against the ear and the pressure helps with the pain. That's the only thing I have besides medications and my heating pad that help me at all with the pain.

Hang in there Kerry and don't stop trying to find a neurologist to help you...they are out there.

Thanks again for taking the time here. I want to hear how things are going for you. Please keep me posted...thanks!

PeacenLove

Always~Laurel

kerry said:

Laurel

I can relate to your story in so many ways :). Death wish, to incorrect diagnosis', to so many meds, horrible nerve block experience for the last 2 years.

I too started off with the worst earache I've ever had in my life. I told everyone it was like a screw driver in my ear 24/7 and all the doctors kept trying to treat the "hematoma" or large purple polyp in my ear with ANTIBIOTICS for months. I had nerve damage hearing loss, nystagmus, nausea, low grade fever, swollen glands, and pin size red dots all over the body. The 5 ENT's I saw never put or thought to test me for shingles. Just recently a Godly friend of mine came across literature online that may have found the reason for my pain-Post Herpetic Neuraliga. After my Mastoidectomy in 2012 to remove the blood clot in my ear and now that the pain has traveled to the nerves in my face, eye and arm, I am trying to get into an infectious disease doctor.

Sorry, I know we have a discussion on another page, but this was a more concise way on giving you my background and hope it makes more sense. I'm just so frustrated and don't quite understand how a doctor is not connecting the dots. It is so utterly frustrating that they keep wanting to give me pills to treat the symptoms rather than help me find the cause.

Thanks so much for opening up and sharing your struggle. I would love to hear more about your tests and how you got doctors to listen to you. I hope you are well and feeling better and your treatments are helping you! Please keep us posted :) Take care!!


Where can I find this printout for the ER?
shinglesdidit said:

Sweetie, I think you should ask your primary for a referral to a neurologist/neurosurgeon as soon as possible. Your's sounds like geniculate neuralgia and it can be caused by various things. There is also a printout circulating around here that tells ER doctors about your pain...sometimes we can't even talk when we're having attacks....with this printout you just have whomever takes you to ER, hand it to your ER Doctor along with your med list and General Physicians info. When I went in for my shingles initially, I was having more pain in my ear than where the rash was. They told me sadly that there was nothing going on in the ear that they could see...but they did document my complaint so that when I did finally see a NS that would listen, that info was there for them to read...not just me telling them from my own memory.

Don't stop your search for a neurologist/neurosurgeon. They are the ones that have any chance of helping us. Use the Doctors Tab and look for ones in your state/area and write to them. You'll be able to weed out the not so experienced in this disease from the ones who can actually help you by communicating with them prior to an appointment. Good luck with this. I want to hear what you come up with so please accept my friendship so I can follow your case.

Thanks for stopping by and taking the time.

PeacenLove

Always~Laurel

weirddiagnosis2013 said:

They can't find the reason behind my gn...no vascular nerve involvement,son mri, so I'm back to square one, ending up in the er every two weeks, with attacks in between. Feels like a bad earache with excruciating stabs in my eardrums...the er treats me like I'm crazy. My primary told me to put cotton in it during attacks...no way can I touch my inner ear. I'm on tegrtol and topamax...don't know how long I can take those. Any ideas...help, anyone!


http://www.lawhern.org/AttendingPhysicianAdvisory.doc
Here you go, very handy when speaking is impossible.


DR. J said:


Where can I find this printout for the ER?
shinglesdidit said:

Sweetie, I think you should ask your primary for a referral to a neurologist/neurosurgeon as soon as possible. Your’s sounds like geniculate neuralgia and it can be caused by various things. There is also a printout circulating around here that tells ER doctors about your pain…sometimes we can’t even talk when we’re having attacks…with this printout you just have whomever takes you to ER, hand it to your ER Doctor along with your med list and General Physicians info. When I went in for my shingles initially, I was having more pain in my ear than where the rash was. They told me sadly that there was nothing going on in the ear that they could see…but they did document my complaint so that when I did finally see a NS that would listen, that info was there for them to read…not just me telling them from my own memory.

Don’t stop your search for a neurologist/neurosurgeon. They are the ones that have any chance of helping us. Use the Doctors Tab and look for ones in your state/area and write to them. You’ll be able to weed out the not so experienced in this disease from the ones who can actually help you by communicating with them prior to an appointment. Good luck with this. I want to hear what you come up with so please accept my friendship so I can follow your case.

Thanks for stopping by and taking the time.

PeacenLove

Always~Laurel

weirddiagnosis2013 said:

They can’t find the reason behind my gn…no vascular nerve involvement,son mri, so I’m back to square one, ending up in the er every two weeks, with attacks in between. Feels like a bad earache with excruciating stabs in my eardrums…the er treats me like I’m crazy. My primary told me to put cotton in it during attacks…no way can I touch my inner ear. I’m on tegrtol and topamax…don’t know how long I can take those. Any ideas…help, anyone!

Weirddiagnosis...goofed up on this yesterday and replied to another poster....sorry....here's my comment to you!

Sweetie, I think you should ask your primary for a referral to a neurologist/neurosurgeon as soon as possible. Your's sounds like geniculate neuralgia and it can be caused by various things. There is also a printout circulating around here that tells ER doctors about your pain...sometimes we can't even talk when we're having attacks....with this printout you just have whomever takes you to ER, hand it to your ER Doctor along with your med list and General Physicians info. When I went in for my shingles initially, I was having more pain in my ear than where the rash was. They told me sadly that there was nothing going on in the ear that they could see...but they did document my complaint so that when I did finally see a NS that would listen, that info was there for them to read...not just me telling them from my own memory.

Don't stop your search for a neurologist/neurosurgeon. They are the ones that have any chance of helping us. Use the Doctors Tab and look for ones in your state/area and write to them. You'll be able to weed out the not so experienced in this disease from the ones who can actually help you by communicating with them prior to an appointment. Good luck with this. I want to hear what you come up with so please accept my friendship so I can follow your case.

Thanks for stopping by and taking the time.

PeacenLove

Always~Laurel

weirddiagnosis2013 said:

They can't find the reason behind my gn...no vascular nerve involvement,son mri, so I'm back to square one, ending up in the er every two weeks, with attacks in between. Feels like a bad earache with excruciating stabs in my eardrums...the er treats me like I'm crazy. My primary told me to put cotton in it during attacks...no way can I touch my inner ear. I'm on tegrtol and topamax...don't know how long I can take those. Any ideas...help, anyone!

hi Laurel, im thinking you will be happy to hear your not alone ! I too had shingles which have destroyed my life, the first time they were in my eye which caused a severe headache lasting 11 days and 3 trips to the ER and them misdiagnosing me with a migraine before i became paralyzed and they took me seriously and found by that time my brain was very swollen. Encephalitis from shingles in my eye or from a mmr vaccine i had ! alot to digest right ? well I was only 29 then and recently I have had shiingles in my ear twice and now the oh so lovely TN is joining in on the rare diseased me ! I am now gonna be 43 and get treated like a drug seeker here in the lovely FL and doctors are really ignorant to me. Im still trying to get help and it seems that i can only help myself because the docs arent willing to learn from a rare person like me. so here I am learning and researching as much as i can

Hello and I am so sorry! So you've had PHN since you were 29? My God how has this gone on without good neurologist?? I can't imagine! Have you been to a ENT?

See, I have no pain in on or around my ear. I had shingles actually in my brain, on the Geniculate Nerve itself. They can see the scars on MRI. I also had a severe rash on my Left thigh, same side of the body. My shingles presented 3 days prior to the rash, with the unbearable earache that was worsened by cold or even the slightest breeze. Not a shingle one in/near my ear.

I have no doubt that you have had damage to your ear! Over and over again! Just not the same way I did. You should check the DOCTOR tab at the top and look to see if there are any that members have noted one/several in your area. If you can travel for care that's a different story.

Did you by any chance get the vaccine? I'm just sure if I do I'll get them again...I've already had them invade my noodle, don't want to give them access to OWN me! Even after brain surgery I know that to be a no brainer.

I have come to a standstill of sorts with progress. Just don't miss a dose of anything! I have bouts of breakthrough pain, not too bad. I figure I'm lucky :)

I will talk to you soon I hope, so I can help you get somewhere. You might also want to post a discussion about your journey so far and when you do, let me know so I can get a mod to FEATURE your discussion so you'll get so much more help.

We've got to get you some help!

Be sweet to yourself, Always~Laurel

Hi laurel- I’m so glad you posted this before I go to see my new neurologist on the 9th… I too have had a few bouts with shingles (mine on my face), but the neurologist I was seeing was confused with my pain symptoms, going back and forth with whether it’s TN, PHN, both… He gave up & sent me to pain management. I have the pain in my ear, face, neck and arm (like Kerry). I’m having an MRI/MRN next week & praying that will shed some light on what’s going on. I’m apparently very sensitive to meds, and haven’t been able to tolerate any of the standard meds. So I’ve just been suffering with the pain for the past year.

Nicole

Hi Laurel, so forgive me if I am confused (that happens often with a brain injury ) but if you mean post herpetic neuralgia when you say PHN then yes I have had it since I had the shingles in my eye that got into my brain and caused the encephalitis and I was only 29. I will not get the vaccine because the neurologist that saved my life wasnt sure if the MMR vaccine i had or the shingles caused the brain to swell and he told me not to ever get any vaccines. I just recently got the trigeminal neuralgia and although im sure i would of gotten it at some point from all the damage , i think the dentist caused it to start because when he did a filling on my lower back tooth the pain from the lidocaine injection was insane and i knew he did something wrong ! right after that I had my first episode of the TN and its kept on going since. I am going to try to goto the docs recommended on here, it will take time as the insurance makes it hard to change everything and florida makes it incredibly hard to get any pain meds....


hope your doing ok and thanks for writing

sally

I had dx Ramsey hunt after severe head throat neck eye shingles and proceeded to get shingles two more times in throat ear face neck. Suffered a lot two years. Looked at GN diagnosis also at this time due to severe throat pain.
Are you on valtrex all the time? Was told by infectios disease specialist I have chronic shingles . So each episode caused more scaring more nerve and muscle damage. Have shingles all the time ready to come out in same area.
Did accupuncture to face with electric stim by old Chinese accup. Worked for few weeks took away majority of nausea throat pain and facial pain and muscle knots. My best treatment is Botox and nerve blocks to trigeminal and back of head and trap muscles .It stopped the severe muscle and nerve pain. I supplement it with Percocet as needed naproxen and metalaxon a muscle relaxer. Zofran for nausea. Cepacol numbing lozenges for throat pain.
Hope this helps.
Try the accupuncture it’s been around for long time. You do need the electric stim for it to work.
Keep in touch so sorry for your suffering. I’ve been at this since 2012
My shingles was all inside my head and throat. Could not see anything on skin except one vesicle. Thought I had a stroke as it affected my tongue and speech and swallowing.
I know what you are going through about needing psychotherapy it feels like PTSD.

Laurel you call yours shinglesdidit. I called mine shitinthehead lol

I am so sorry that you are going through this. I have GN as well - that was cured with an MVD.

I totally understand where you are coming from, and where you are right now.

If you ever want to chat, or have any questions about my experience, feel free to add me as a friend and or email me.

Smash


I think you need straight up pain killers, Norco, oxycontin,Neurontin on a regular schedule to deal with the pain...the others don't do diddly I don't think..maybe the Cymbalta, it works as both an antidepressant and anti spasmodic for the nerves. Let me know what you think. Thanks for taking the time here :)

Always~Laurel
weirddiagnosis2013 said:

They can't find the reason behind my gn...no vascular nerve involvement,son mri, so I'm back to square one, ending up in the er every two weeks, with attacks in between. Feels like a bad earache with excruciating stabs in my eardrums...the er treats me like I'm crazy. My primary told me to put cotton in it during attacks...no way can I touch my inner ear. I'm on tegrtol and topamax...don't know how long I can take those. Any ideas...help, anyone!