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Right mastoidectomy done, atypical petrositis. Blood tests show fluctuating blood sugar. Sounds serious?

KM Arumugam, 75 years, known diabetic for 25 years, IHD 13 Years, Old CSOM operated 3 months ago. Right mastoidectomy done 14-Mar-2012, Atypical petrositis on regular medication. Now presented with relapse of the pain in the right temporal region and right V1 V2 division. Initially feels better with Ketarol and Lyrica but now the frequency and duration of pain is more. Examination revealed Tongue normal. No deviation in jaw Limbs normal, DTR present plantar bilateral flexor, Pinprick normal. Blood tests show fluctuating blood sugar. CT scan brain showed Hypodensity in right parietal lobe suggestive of gliotic changes due to old infarct. ENT opinion obtained Rigid nasal endoscopy done. Nasopharynx visualized. No pathology seen. Advise to treat as atypical neuralgia . During his stay developed loose stools and hypoglycemic attacks. Diabetologist opinion obtained, OHA started. Even with tegretal, Lyrica and ketanov and other medications pain is still persists. Kindly advice for further treatment.
Asked On : Fri, 29 Jun 2012
Answers:  1 Views:  39
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Diabetologist 's  Response

The ENT is make a provisional diagnosis of Atypical neuralgia.
The pain which you're experiencing is a neuralgic pain.
Medication will do very little to reduce the pain.
You need to be started on antipsychotic drugs to manage the pain.
Answered: Tue, 11 Jun 2013
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