Dr. Shapira's Chicago Headache Blog

* required |Privacy Policy

Monday, March 21, 2011

Shooting pains in the head and face. Is Trigeminal Neuralgia the Cause? Why did MVD brain surgery not help?

Melanie: I have had root canals, anti seizure meds I could not tolerate, and on 12/30/10 I had MVD brain surgery. I still have pain and shocks in my facial area, teeth, ears and the back of my head (cannot lay down). Am currently seeing a doctor that is giving me occipital nerve block injections. Just saw the doctor at Duke who did the MVD surgery and he admitted that his surgery did not fix the problem and they don't have anything else to offer me. I am seeing an oral surgeon in Vinton, VA on 3/28 for a TMJ consultation, but I went to UNC-Chapel Hill school of dentistry last year for an evaluation and was told that my TMJ is not causing the neuralgia and shocks. I am so light sensitive I cannot go outside or watch TV. I cannot talk on the phone without getting shocked so please do not call me. I cannot chew without causing an increase in shocks. Sometimes by the evening hours I cannot talk but have to write notes to communicate with my husband. I have had neck problems fo r years, treated by chiropractic. In fact the shocks started after a rather aggressive chiropractic neck adjustment (in June 2010).

Dr Shapira Response: Dear Melanie,

I am sorry you are having to bear so much pain. I know it is not easy. Are the occipital nerve blocks helping? The fact that the Microvascular decompression did not help probably means it was not the source of the problem.

Have you tried a spenopalatine ganglion block? The SPG block can be done as an injection or through the nose. It addresses the autonomic potion of the trigeminal nerve. The nasal block can be easily and painlessly self administered on a daily basis for 20 minutes (one or more times a day) and can give miraculous results for some patients.

It is unlikely that you will find an oral surgeon who understands neuromuscular (NMD) dentistry. I have seen incredible results with NMD but it can be a problem depending on where your trigger locations are. You may not have a "TMJ" problem but have problem with masticatory system and trigeminal nerves. CRPS (chronic regional pain syndrome) is also a possibility.

Do you have a specific trigger area or spots that can be identified? It is also possible that a medially displce disk can be pressing on the trigeminal nerve. This could be addressed surgically.

How long ago did this problem begin? Did the Chiropractic adjustment exacerbate or start the problem? If it really stated immediately after chiro adj you might want to consider having a stellate ganglion block.

I usually try to avoid surgical procedures initially as frequently surgery can make problems more severe. Did the severity change following surgery, for better or worse or was the pain just unchanged?

Labels: , , , , , , , ,

posted by Dr Shapira at 1:31 PM

Welcome to the iHATEheadaches website, please upgrade your Flash Plugin and enable JavaScript.