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Had a nasal injury. Experiencing pain in left side of body. Possibility left hemicrania continua. What to do next?

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i had an nasal injury 10 years back when i was fighting with my brother .i suffered a huge blow to my left part of face and my nose bleeded from that side.We didnt consulted any doctor at that time because bleeding stopped after putting water and cotton.Now at age 22 i am experiencing something unusual by looking at the face.I have a facial pain and pain above left eye and behind left neck and lower left part of brain and through left ears.The pain is continuous throughout the day.Stabbing or I Feel continuous pain through above left eye and left brain and ears and sometimes facial pain.The pain is sometimes triggered by movement of neck.I observe my left body part are weaker as compared to right body parts on the basis of nerve Muscles and my left part of face where pain is sometimes experienced and my left brain measures small as compared to right brain and left shoulder and joints and hands appear to be weaker than right parts and my left jaw is smaller than right.I recently heard about nostril not of equal sie.I wanted to ask if these problems are because of injury i had in my childhood.I had consulted a neurologist about that and he suggested that it could be left Hemicrania continua and suggested me to have and MRI of Brain and Spine.The problem has been around since 5 years from now.I wanted to ask whether i should Go to ENT specialist or i should First continue treatment from neurologist after MRI.I have attention problem .I cant pay attention to anything for a long time. I wanted to ask is there any relation to all my problems to the nasal injury which i had in my childhood
Posted Fri, 16 Aug 2013 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Sumit Bhatti 2 hours later
Hi,

Thank you for your query.

1. Trigeminal Neuralgia is a possibility according to your symptoms. Medications such as amitriptyline, carbamazepine and gabapentin may help.

2. Hemicrania continua would respond to medication such as indomethacin and cox-2 inhibitors.

3. Along with the MRI, get a CT PNS (Para Nasal Sinuses) and an MR angiogram. A blood vessel pressing on a nerve root entry/exit zone may be responsible.

4. Any relation between the old nasal injury and the present condition cannot be conclusively proved. Chronic pain may also affect the way in which the brain perceives pain.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Had a nasal injury. Experiencing pain in left side of body. Possibility left hemicrania continua. What to do next? 9 minutes later
The images which i have send you regarding nasal septum deviation.I wanted to know that i should continue treatment from neurologist or i should go for ENT specialist and i wanted to know what could be cause of the weakness of left parts of my body my shoulder and left part of face and facial pain
 
 
Answered by Dr. Sumit Bhatti 30 minutes later
Hi,

Thank you for writing back.

1. You can consult an ENT Specialist only after a CT PNS Scan and a trial of the medication that I have suggested (with your Neurologist).

2. DNS is a very common finding in up to 60-70 % people and is related to the differential growth rates of cartilage and bone. DNS may be treated only if the symptoms are persistent. Most people require no surgery.

3. Weakness may be measured by the Neurologist. If your Neurologist is unable to prove the weakness and if your MRI is normal, then it may just be be a common finding where the dominant side of the body is stronger. Are you right-handed or left-handed?

4. The facial pain may be Trigeminal Neuralgia, Hemicrania Continua or mucosal contact within the nose (this will be visible on the CT Scan and nasal examination / endoscopy) . A trial with the medications and the tests that I have suggested will settle the issue.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
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