Brief Answer:
You will need a workup

Detailed Answer:
Good evening. My name is Dr. Dariush Saghafi. I would like to give you a bit of information that will help answer your question.

You are suffering from dizziness and pain in the head and neck which gets worse at night and this has been chronic for the past 3 months. You report occasional numbness in the face of seconds duration and "sinus" pain but it's your usual pain.

Your question is whether or not this could be Temporomandibular Joint Dysfunction.

It would be helpful if you could clarify the following questions for me:

1. What exactly are the "sinus issues" diagnosed by ENT if you could be specific and how exactly were these diagnosed (i.e. CT scan of the sinuses, physical examination, DIRECT visualization?)

2. Please define "dizziness". Do you mean a sense of lightheadedness or is it true VERTIGO (spinning feeling, or sensation of movement which can be brief and sudden).

3. Describe the pain in the back of the head/neck. Is it a burning sensation, a sharp/jabbing sensation, does it feel like an achiness, or a prickly sensation? Is there anything that makes the pain better or worse that you're aware?

4. Which part of the face is numb? Upper, middle, lower face? Left side, right side? Around the mouth, inside the mouth, tongue? When does this numbness occur?

5. What do you mean when you say "SINUS PAIN?"

The above questions will help clarify a few issues that could allow us to determine whether this pain is "head" based or "neck" based or something totally different.

Could these be primarily the symptoms of TMJ? Based upon what you've presented I would say the likelihood is small and here's why-

Although head and neck pain can be part of the total "pain package" that one may experience with TMJ by far the most important complaints that people have with TMJ is jaw and mandibular pain especially upon chewing and swallowing due to the misalignment factor. Also, there is locking of the jaw. There are often ear pains which can be stabbing. People also complain frequently of clicking or grating sounds upon opening and closing their jaws.

Based upon the conspicuous lack of any of these very common and primary symptoms of TMJ in your description I would have to say that there would only be the smallest of chances that your symptoms could possibly be due to TMJ. Also, facial numbness for seconds at a time is not a commonly recognized symptom of TMJ.

As a neurologist, I believe your symptoms are much more compatible with some form of headache syndrome which is chronic due to the amount of time you've had it (3 months) as well as the description itself of the neck pain which causes dizziness and facial numbness. These symptoms are much more consistent with a headache type of syndrome rather than TMJ.

I hope that I've been able to answer your question with valuable information and if so I'd very much appreciate some written feedback so as to gauge how well I was able to answer your question.

I also would be very pleased if there are no more questions or comments on this thread if you would CLOSE THE QUERY on your end which then, allows the network to credit me for the work and have your response archived for future reference.

All the best.

This query required 60 minutes of physician specific time to review, research, and document for the final draft and envoy.

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