6 years ago i decided it's time to fill of my cavities, i had no pain not even a little it was "preserve" treatments. And then one day after i did in tooth 37 a preserve filling, right away after the anesthesia went off a pain started and as you know if i am here...never left. At first it was like someone drilling in that tooth all the time and after a year and a half it became burning sensation. All of this years no one wanted to give me an MRI, saying there is no need, if it happened directly after a tooth dental treatment and more so if it didn't hurt at all before the procedure. All physicians stated it's a nerve injury. So i believed and tried to live with it. the last year was awful and "triying to live with it" didn't work any more. So i became more active and less good girl with the doctors. MRI i got from a shiti neurologist after i told her i am not getting out of the room without MRI for the brain. She twisted her face and said fine, giving me the feeling like i steal something....
So the story became wierd and shocking. They found on the MRI a Cerebral artery on the nerve....I don't know what to think any more, a classic diagnosis of TN with not classic symptoms. It never hurt before the dental procedure, the pain is more in the tooth (37 molar) and projecting to frontal tooth and that's it, there is no big pain in the jaw maybe a little, not involving V2 nor V1, not electric shocks, i can speak, i can touch my face, i enjoy eating because it's the only thing that calm the pain, and again the pain is mostly in that tooth.... i can't believe it....please help me if you can direct me what is wrong with me??? what category am i belong???
For the record i have two friends with a story resemble to mine, with all this dental thing, both of them found veins on the nerve (i don't think that they found the Cerebral artery). one did MVD and it didn't work.
Ravit
From the circumstances you describe, my best guess is that you are indeed experiencing facial neuropathic pain caused by a dentist's error in administering anesthetic to the lingual nerve, causing injury to the mandibular (V2 or V3) branch of the trigeminal system. This pain doesn't sound like the "idiopathic" facial pain of atypical TN, though I would expect dentists to stoutly maintain that the pain is only coincidental to dental treatment.
The distinction isn't terribly important. In both cases, the medical treatments are pretty much the same. Although an artery has been detected in contact with the trigeminal nerve, very few neurosurgeons will likely be willing to attempt surgery unless you have the classic symptoms of Type 1 TN -- the electric shock lightning-strikes of pain that come and go. That doesn't seem to be the case.
The anti-seizure meds should be tried, but its more likely that you'll respond to moderate doses of a tricyclic anti-depressant like Amitriptyline or Nortriptyline, possibly in combination with an anti-inflammatory steroid, an anti-convulsant "booster" like Baclofen, Neurontin, mild muscle relaxants like Flexeril or even a mild low-dose tranquilizer like Valium. NOT all at the same time, of course. Your neuro will need to try you on one or two meds at a time and see how you respond.
Go in Peace and Power
Red
PS: For your own safety, be advised always that I am not a medical doctor. Though I've been talking with face pain patients for 17 years, my Ph.D. is in systems engineering.
Ravit,
I really don't have any answers for you, but I can definitely relate to your symptoms. My pain too began after a dental procedure and has never left. My neurologist has never specified between Type 1 or 2/classic or atypical TN but from what I've read I would definitely consider mine to be Type 2/atypical. I too can speak, eat, and touch my face without worsening pain and I do not experience the classic TN symptoms including electric shocks. I just have constant facial pain, mostly in my teeth, that never ever goes away. I had no trouble getting an MRI and many other expensive tests, but most were inconclusive. I'm currently working with my neurologist and trying anticonvulsant medication. I found partial relief with a combination of Tegretol and Lortab, but had to discontinue Tegretol due to photosensitivity and my neuro is weaning me off of Lortab (I assume because he doesn't feel comfortable prescribing narcotics long-term). Right now I'm on Trileptal, which has provided much less relief. I wish I had more answers, but can only offer similar experiences and let you know that you're not alone on this journey. Good luck to you.
Ginny
Thank you very much for responding