Frontal and Occipital Headaches with Facial Numbness

From Vicki:

I have right sided pain in the occipital region and frontal area. Continuous pulsation with buzzing in my ear. I am Nauseated, and have right sided facial numbness and tingling.

Dr Shapira response:

I always suggest patients with numbness in the face have a neurological work-up and patients with ear problems be evaluated by an ENT. Having said that I frequently see patients with symptoms similar to your who are very successfully treated by their diagnostic neuromuscular orthotic without drugs.

The occipital pain is usually referred from neck muscle trigger points, especially from the SCM, Trapezius,
Levator Scapulae,,splenius capitus and splenius cervicus muscles. Patients who have had long term pain may also have occipital trigger points or entrapment of occipital or greater occipital nerves. An occipital nerve block can have amazing results. Facial numbness may be from occipital nerve entrapment.

The buzzing in the ear and pulsation is usuallly from problems with the tensor palatini muscle (affects eustacian tube) or tensor tympani muscle which goes to the ear drum.

One must consider the facial nerve as well as a cause of numbness and that can be related to parotid problems.

The Trigeminal Nerve is always the primary source of frontal headaches and involved in most parietal and occipital headaches due to postural implications.

The pulsing of the Trigeminal Nerve and Facial nerve with ULF (ultra-low frequency) TENS may eliminate all problems if a diagnostic orthotic is also constructed.

Following complete (or close) pain relief a long term solution can be evaluated.

Dental work percipitates severe pain problem.

I frequently hear stories of patients who have severe circumstances that result from relatively non-invasive treatment. An example below is the letter I just received.

A temporary crown placed in the middle of January 2010 caused horrible face pain, eye pressure stabbing ear pains, refered tooth pains, migraines on opposite side of normal, facial numbness and neck spasms. Extreme pain for about 7 weeks. Pain is still persistant but now at tolerable levels.Two trips to endodontic clinic sent me to Neuralogist who did MRI and MRA and diagnosed me with Neurological disorder triggered by dental work. It is time to put on crown permanently. Neurologist says next event could trigger more intense an longer lasting pain. Is there any dentist in Wichita, Ks. who might cause less trauma with this procedure? Neurologist next wants to do a sleep study to see if improper night oxygen levels could be causing overactive nervous system and delayed healing. Would love to hear your comments! Thank you for your consideration, B.A.

The question is what set off this problem? Usually there were existing problems already present and the new crown was the proverbial "strw that broke the camels back". It is possible that the crown was too big or changed the bite but it is also possible that merely having the mouth open for an extended appointment was enough to create the problem. Regardless, once the problem is in full glory it often takes more than just correcting the crown to fix the problem.

The basic principles of neuromuscular dentistry is to idealize position of the jaw, the jaw muscles, the jaw joint and the bite to a position of minimal adaptation for healing. Neurological problems related to the trigeminal nerve will frequently self correct.