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Suggest treatment for atypical trigeminal neuralgia

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Posted on Wed, 20 May 2015
Question: i have been diagnosed with trigeminal nerve problem with nose. It is bright red when i awake and is painful to some degree all the time but especially in the night. When i wake in the night , which is often, my heart is working hard and i have to sit up for a while to calm down. I have a type Atypical trigeminal problem with left side of face. i worry about my heart. what can i do? i thought that i had cellulitis on the nose tip but it appears that an old scar is probably reacting to nerve problem.
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Answered by Dr. Riyanka Chail (13 hours later)
Brief Answer:
kindly consult a otorhinolaryngologist (ENT doctor) and a psychiatrist .

Detailed Answer:
Hi XXXX,

Thanks for writing in to us.

This is Dr.Riyanka and I am glad to be helping you with your query.
Atypical trigeminal neuralgia ( type 2 trigeminal neuralgia )is a form of trigeminal neuralgia, a disorder of the fifth cranial nerve.

This form of nerve pain is rare and the symptoms overlap with several other disorders , thus difficult to diagnose.

The pain can be described as heavy, aching, stabbing, and burning and associated with migarine like headache.
40 mg Cymbalta(Duloxetine) is an antidepressant used for various mental/ mood disorders.
Tramadol is a narcotic like pain reliever drug used for the pain in trigeminal neuralgia.

Ask your doctor before using tramadol together with Duloxetine (Cymbalta).
Combination of these two medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as hallucination, seizure, extreme changes in blood pressure, confusion, , increased heart rate, fever, excessive sweating, blurred vision, muscle spasm or stiffness, tremor, stomach cramp, nausea, vomiting, and diarrhea.

As of now i advice you to kindly consult a otorhinolaryngologist (ENT doctor) regarding trigeminal neuralgia and a psychiatrist regarding the drug interactions between tramadol and cymbalta.
Hope this answers your query. Don't worry .
Do write back if you have any further doubts.


Get well soon
Dr.Riyanka

Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Riyanka Chail

General & Family Physician

Practicing since :2009

Answered : 818 Questions

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Suggest treatment for atypical trigeminal neuralgia

Brief Answer: kindly consult a otorhinolaryngologist (ENT doctor) and a psychiatrist . Detailed Answer: Hi XXXX, Thanks for writing in to us. This is Dr.Riyanka and I am glad to be helping you with your query. Atypical trigeminal neuralgia ( type 2 trigeminal neuralgia )is a form of trigeminal neuralgia, a disorder of the fifth cranial nerve. This form of nerve pain is rare and the symptoms overlap with several other disorders , thus difficult to diagnose. The pain can be described as heavy, aching, stabbing, and burning and associated with migarine like headache. 40 mg Cymbalta(Duloxetine) is an antidepressant used for various mental/ mood disorders. Tramadol is a narcotic like pain reliever drug used for the pain in trigeminal neuralgia. Ask your doctor before using tramadol together with Duloxetine (Cymbalta). Combination of these two medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as hallucination, seizure, extreme changes in blood pressure, confusion, , increased heart rate, fever, excessive sweating, blurred vision, muscle spasm or stiffness, tremor, stomach cramp, nausea, vomiting, and diarrhea. As of now i advice you to kindly consult a otorhinolaryngologist (ENT doctor) regarding trigeminal neuralgia and a psychiatrist regarding the drug interactions between tramadol and cymbalta. Hope this answers your query. Don't worry . Do write back if you have any further doubts. Get well soon Dr.Riyanka