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Feeling of bug crawling under skin on temple, painful, skull pressure. Worried about giant cell and temporal arteritis

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General & Family Physician
Practicing since : 1993
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The right temple (although it can be my left) feels like a bug crawling under the skin and the pain is excruciating - its like a golf ball trying to pass through my artery. At its worst I can see in the mirror the artery moving and its as though my skull is being moved with the pressure. I am worried about Giant Cell and Temporal Arteritis and worry it could be serious. I dont think its cluster headache as its not that frequent but when it hits its like my head is being stabbed. My eye sight is fine with no blurred vision. Any advise would be welcome. Thanks, XXXXXXX
Posted Sun, 22 Apr 2012 in Brain and Spine
Answered by Dr. Shainaz Arif Kaware 46 minutes later

Thanks for your query.

The sort of pain you have described that it is excruciating, and as it is not frequent the first thing that comes to mind is Trigeminal neuralgia.

There is a confusing thing in your question and it is part of the first line -The right temple (although it can be my left).

Please answer these few questions to help you better:-
1. Is the pain one sided always? Is it pulsatile? Does it radiate down to the jaw, cheeks, teeth and so on?
2. Does the pain start all of a sudden even while doing daily activities like brushing your teeth, eating, drinking, and shaving?
3. When in pain if you touch the face does it feel tender or does it get increased on touching?
4. Duration of pain whether it lasts for few minutes or hours or more?

Please write back with answers, so that I can give you a better answer.

Awaiting your response

Take care.
Above answer was peer-reviewed by
Follow-up: Feeling of bug crawling under skin on temple, painful, skull pressure. Worried about giant cell and temporal arteritis 59 minutes later
Hello. Thanks for your reply.
The sensation can occur in either temple but predominantly in the right, so it is not one sided. It does not radiate down to the jaw, cheeks, teeth. The "bug" crawling sensation can happen anytime, anywhere and it does come on all of a sudden. Eating can bring it on and using my electric toothbrush with the vibration. Touching the temple when its inflamed/painful is not tender - rubbing the area does ease the pain but i wouldn't say its tender to touch. When it occurs the "golf ball" pain I mentioned can last 15 minutes or so then it goes. The "bug" crawling can last an hour or so longer. I would also say I have a whooshing sensation in my ears when its at its worst and when I lie on my right side in bed, the crawling feeling is worse. This may sound stupid but around Christmas, I was getting a weird secondary pulse in my right ear - a very fast "pulse like" sound in my ear that bore no correlation to my actual pulse whatsoever.

I hope this information provides more of a picture.

Answered by Dr. Shainaz Arif Kaware 54 minutes later

Thanks for reverting back with the answers for the questions.

As there is no tenderness over the temple, the pain is unlikely to be due to temporal arterities.

The details like pain on eating and use of electric tooth brush suggests that it is more likely to be Trigeminal neuralgia. It is a nerve disorder that causes stabbing pains or like electric shock.
The cause is often non specific and in some cases it can be due to pressure on the trigeminal nerve as a result of swollen or dilated blood vessel or ear pathology.

You will need a detailed examination by a physician. He may advise you to get investigated as it is important to find the cause of this pain. Investigations like blood tests, MRI are entailed. And medications like Carbamazepine or amitriptyline will stop the pain and reduce the frequency of the attacks.

So I encourage you to consult a physician at the earliest and discuss regarding your pain and the benefit of the above named medicine to reduce your pain.

Hope I have answered your query. Please accept this answer if you don't have further questions. Let me know if I have missed out on any concerns.

Wish you good health.

Above answer was peer-reviewed by
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