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Having constant pressure and swelling in nose. Getting sinus headache. Is this related to nerve pain?

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Neurologist
Practicing since : 1974
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Hello:

I have had the following problem for many years. I have also submitted my question to an ENT on your website, but I also want to ask a neurologist.

I have a constant pressure and swollen feeling in the lower part of my nose (more notably on the right side), in the roof of my mouth, and in the left side of my chin. Sometimes the left side of my neck feels swollen and I can feel that my pulse is stronger on this side than on the right side. Occasionally, I get very bad sinus headaches around my left eye. When I get these headaches, the pressure I just described isn't present. When the headache leaves, the pressure returns. My dentist and ENT cannot find anything wrong. My chiropractor told me that my neck is very inflamed.

It has been suggested to me that this be a neuralgia. However, when I read about neuralgia pain it sounds different from my case. Is pressure and/or a swollen, inflamed feeling the same as nerve pain?

It has been suggested to me that this might be nerve related.
Posted Fri, 31 Aug 2012 in Brain and Spine
 
 
Answered by Dr. Pratap Sanchetee 12 hours later
Dear XXXXXX

Thanks for posting your query.

I am not able to open report attach with your request. Please send me reports and evaluation by ENT specialist in detail.

With persistent symptom of pain and feeling of swelling & pulsation on one side of face, a vascular cause needs to be considered. Since it is there for many years and no deficit or objective swelling is there on your face, it is likely to be benign.

I am sure routine blood examination e.g. hemoglobin, ESR, sugar, renal functions have been done and they are normal. Your doctor may consider anti-inflammatory analgesic for 1-3 weeks after a full clinical evaluation.

Awaiting your response.

Pratap
Above answer was peer-reviewed by
 
Follow-up: Having constant pressure and swelling in nose. Getting sinus headache. Is this related to nerve pain? 30 hours later
Hi Dr Sanchetee:

Thank you so much for your response. I haven't attached any reports yet, because I don't have any recent tests, etc.

I do have five other questions.

1. I have had all of the blood tests that you mentioned except for the ESR test. I believe that this test measures inflammation, right? I have had two C Reactive Protein test and the results were both high - 3.5 and 4.3. I am not surprised with all the pressure and swelling that I feel in my head. I think that I should request the ESR test, don't you?

2. When you say a "vascular cause", do you mean a vascular tumor? I thought that this might be what you mean when you used the word "benign". I have only heard that word used in reference to tumors.

What kind of a doctor would I see to get this checked?

3. Many years ago (I can't remember how many), I got a horrible, sudden, pounding headache in the left side of my forehead. I could actually hear a loud knocking and banging sound in my forehead. I had never experienced a headache like it before. I didn't have any stroke symptoms. I just laid down and went to sleep for a long time. When I woke up, I felt okay. I asked my primary care doctor about and he dismissed it. But, do you think I could have had some damage that is causing my problems now?

4. Another question that I have is that my eyesight is vastly different in both eyes - my left eye is almost perfect, but my right eye is very bad (about 2200/20). I started wearing glasses when I was 12 and my eye doctors have never seemed concerned about this. And, over the years I didn't think too much about it either. But, I found out recently that the left side of the head actually affects the right eye. With all of my headaches on the left side, and all of the problems that I have on the left side, do you think that my different eyes could indicate a possible vascular tumor?

5. And, finally, I know that this is probably unlikely, but I live in Tampa, Florida in the United States. Do you, by any chance, know of a good doctor or doctors to recommend in the Tampa/Clearwater/St. Petersburg area?

Thank you, again for your help. XXXXXX
 
 
Answered by Dr. Pratap Sanchetee 7 hours later
Dear XXXXXXX,

Thanks for writing back.

1.     I think that I should request the ESR test, don't you?
As CRP has been done, we need not to go for ESR. No additional information we will get it. It is slightly high but no further action is needed.

2. When you say a "vascular cause", do you mean a vascular tumor?
No, vascular cause means mainly inflammation of blood vessels and in most of the cases it is benign. You need to consult a headache specialist. You may need simple anti-inflammatory analgesic for 1-3 weeks.

3.     Many years ago (I cannot remember how many), I got a horrible, sudden, pounding headache in the left side of my forehead.
No damage would be there because of previous symptom long ago.

4.     Another question that I have is that my eyesight is vastly different in both eyes:
No, eye refraction is unlikely to result in type of headache you have.

5.     And, finally, I know that this is probably unlikely, but I live in Tampa, Florida in the United States.
Unfortunately, I will not be able to help you on this count.

Please do write back in case you have further queries.

Regards

Pratap
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