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High cheek bone pain radiating to neck. MRI scan suggests migration spots. Taking advil, benedryl. Any suggestion?

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I am a 38 y/o female. I have severe high cheekbone pain on the right side., under the bone into my right temple and basicly from the hairline all the way back to my neck. I have been dealing with this for one year, however only recently at the end of Feb, beginning of March has this pain intensified. (on a scale form 1-10 I put it at 11). There is no rhyme or reason to it I can get a "pain attack" as I'm calling it at any time. More frequently they are severe after I work out at the gym but not during my work out. I have had a CT scan which showed nothing. I recently had an MRI. The Dr. said I have no blood clots or tumors-a relief--but I have "migrane spots" I saw bits and pieces of the MRI and I do have white spots- I saw them. This pain has gone from coming and going to constant only the level of severity changes. I currently am taking advil and Benedryl over the counter, was perscribed Vicodin for pain. At one point I was taking Indocin but that literally did nothing. I also take Sprionolactone twice daily (past 5 years) and Minocycline twice daily (past 5 years). I am at a loss because I never get sick and do not like taking meds but have to because again, the pain is so severe. There must be something more going on? Could I have a blocked sinus? Would a MRI show that? The conditions are good to be able to see it--spring allergies etc. However I have no stuffy nose or any other symptoms. I XXXXXXX with my neurologist tonight but from what he seems to say he can't find anything wrong. I know there is though. I liken this pain to childbirth. I had migrane with XXXXXXX As a child but they were food induced and never isolated to only one side. As stated this originally started when I was sick with a head cold and laryngitis last February. It seemed to not go away, I was given very strong antibiotics and it never truly went away. I got the CT scan in August ENT said everything looked fine so referred me to neuro who I saw in Ocotober of last year. at that point they were saying facial pain. They continue to say facial pain but it has graduated into my temple higher along my cheekbone and into my head. When I apply pressure to anywhere on my right side of head and face it hurts more. I'm frustrated and it is hard to work or do anything feeling this way. I need to know what kinds of questions to ask neuro when I see them today.
Posted Mon, 22 Apr 2013 in Bones, Muscles and Joints
Answered by Dr. Gopal Krishna Dash 33 minutes later

Thanks for the query,

I understand your problem

I have gone through your medical history and the data that you have posted. I am very sorry to note that you are in agony and till now no cause has been found out. But remember that your worry may worsen your pain.

I think that based upon the data you have posted you could have atypical facial pain. Some of the patients with these problems may not respond and investigations may not yield. The medications that may be helpful are Carbamazepine, Gabapentine, Pregabaline etc. If you do not respond, you need to get jopintly evaluated by a neurologist and Pain medicine specialist. The other procedures that can relieve the pain are various interventional procedures, will be discussed by the pain physician.

I hope that this will help you
Please get back to me after you find this answer. I will be happy to help you.

Best wishes
Dr Gopal K Dash MD, DM, Post-doctoral fellowship (Epilepsy)
Consultant Neurologist and Epilepsy specialist XXXXXXX Hrudayalaya Hospital, Bangalore
My Blog in the Web site:
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