Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
146 Doctors are Online

Has debilitating headaches. Is it trigeminal neuralgia, cluster headache, migraine or hemicranias?

Dear all This is in regards to my wife, who is 37- years old originally born in India and migrated to England in 2003. She has a BSe degree in Nursing and worked as a registered nurse in a hospital outside London. She is currently married and has a six year old son. My wife has had some dental work; tooth extraction with braces in 2004. She has been suffering from left sided chronic headache disorder for five years but increasingly worst since the beginning of year 2008. Due to her increasing and ongoing chronic headaches, she is unable to work at this movement. She has one sided headache(left) from the centre point of head involving, left side eye, cheek, lower jaw, neck, ear, and shoulder, all on left side all the time. She has seen numerous specialists regarding this problem including several neurologist both here in England and in India. She has been further investigated by ENT, Maxillofacial surgeon, chronic pain specialists and Rheumatologist who have given her various diagnosis such as trigeminal neuralgia , cluster headache , migraine, hemicranias, facial pain, post natal hormonal changes and other diagnosis. She has had several investigations such MRI, CT scan, Lumber puncher; results being normal. She is waiting to have PET scan soon. She has had physiotherapy, Acupuncture, Ayervedic treatment so forth which has not been helpful till now. She has had repeated blood works done and her ESR (High Erythrocyte Sedimentation rate) and CRP (C Reactive Protein) have noted to be high most of the time. Numerous above specialists have tried treating my wife with several medications such as : Propanolol, Diazepam, Toprimate, Sodium Valporate, Carbamezipine, Pregablin which have been discontinued in overtime as they have not been helpful. She is currently prescribed with Amitriptyline 75mg daily at night and Oramorph (Morphine Sulphate) which have noted to be helpful to a certain extent but not ultimate cure. My wife continues to experience debilitating headaches as no one have been able to find a definitive diagnosis or treatment up to today. The exact cause of her headaches has proven very difficult to pin down by the above specialists. I would greatly appreciate for your opinion and any help that you can offer her as her headaches are effecting the whole family in all aspects on a daily basis. Thank you Sincerely, GM
Asked On : Sun, 27 Jan 2013
Answers:  5 Views:  195
Report Abuse
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Diseases and Conditions
Medical Topics
Dentist 's  Response
dear friend.

thanks for giving us complete history of your wife`s treatment.

trigeminal neuralgias are seen commonly in people staying in cold countries.if it is so

it can be treated surgically by peripheral nerve block,retrogasserian microvascular decompression and radio surgery.

you can also contact a vascular surgeon for opinion.

hope this helps.


Answered: Mon, 25 Feb 2013
I find this answer helpful
Dentist Dr. Mallayya Pujari's  Response
Dear Mr Gopal,

First of all, thanks for giving a complete history of your wife's problem. Well being a oral medicine specialist I do have seen more number of trigeminal neuralgia and other neuralgia cases. Your wife's case I guess is not associated with any neuralgia.

It could be a migraine of either neurologic or a vascular origin. Kindly take a opinion from vascular surgeon as well.
Answered: Thu, 14 Feb 2013
I find this answer helpful

4 Doctors agree with this answer

Dentist Dr. Farah Hussain's  Response
hi and welcome to HCM,

Trigeminal neuralgia is the neurological pain commonly seen affecting people is cold regions of the world. Treatment of this condition can be done by carbamazepine(tegritol ), gabapentin or phenytoin as pain management .

surgical treatment includes peripheral nerve block or ablation,gasserion gangilion and retrogasserion microvascular decompression and stereotactic radiosurgery.

I suggest you to consult an oral surgeon and get the necessary radiographs done like MRI done with close picture of posterior fossa to rule out any mass lesions or large ectatic vessels and vascular malformation leading to compression of the nerve and causing the condition .

Hope this information helps you.

take care,

get well soon.
Answered: Thu, 14 Feb 2013
I find this answer helpful

2 Doctors agree with this answer

Orthopaedic Surgeon, Joint Replacement Dr. Saurabh Gupta's  Response
Feb 2014

Welcome to the forum.
you are suffering from trigeminal neuralgia

A variety of treatments are available, including medication, surgery, needle procedures, and radiation. First line treatment is medication. When medications fail to control pain or cause intolerable side effects, a neurosurgeon may be consulted to discuss other procedures.

For effective pain control, medications must be taken on a regular schedule to maintain a constant level in the blood.


Antispasmodic agents

I hope this information has been both informative and helpful for you.

Answered: Thu, 14 Feb 2013
I find this answer helpful
Dentist Dr. Neha Gupta's  Response

Welcome to the forum.
Your doctor was correct as you seems to be suffering from trigeminal neuralgia.
as medication is used for pain management gabapentin or phenytoin
last option is surgery.
I suggest you to consult an oral surgeon nearby for a detailed examination. A Xray or MRI can be done to rule out other causes
I hope this information has been both informative and helpful for you.
Answered: Thu, 14 Feb 2013
I find this answer helpful
Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
This is a short, free answer. For a more detailed, immediate answer, try our premium service [Sample answer]


Loading Online Doctors....
© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor