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Suggest treatment for stabbing pain in the head while on Gabapentin

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Posted on Tue, 19 Jul 2016
Question: I've had trigeminal neuralgia for 5 days. I've had this many times in the past. It changed to the sharp stabbing pains originating from the back of my head. It would radiate over my head. Now it has settled into the mid-back of my neck. Its a hard pulsing feeling and does not radiate. I've never had this hard pulse feeling before. Its a little scary. I went to the ER last Saturday and they gave me tegretol. I'm on gabapentin for my fibromyalgia. I take them at different times because the two together make me jerky. I'm concerned about this neck thing going on. Do you see any problems or do you think it's just a head nerve pulsing? It pulses hard a lot and makes me feel like I have another issue going on. Your thoughts please.
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Answered by Dr. Olsi Taka (1 hour later)
Brief Answer:
Doesn't look like a trigeminal neuralgia.

Detailed Answer:
I read your question carefully and I understand your concern.

I must say that I agree with you that that type of pain doesn't sound typical for trigeminal neuralgia. Trigeminal neuralgia is typically a facial pain as the face is the territory covered by the trigeminal nerve. It may radiate somewhat to other locations but not be only there. Even the previous pain you describe (originating from the back of the head) doesn't sound like typical trigeminal neuralgia, more like occipital neuralgia (doesn't change treatment much though). This neck pain sounds even less like trigeminal neuralgia.

On the other hand I do not think it to be indicative of a dangerous condition so you do not have to overworry. Might be a flare up of fibromyalgia or may be an neck arthritis related pain (I would try if nonsteroid antiinflammatory medication like Ibuprofen has any effect). If the pain persists though another visit might be indicated and possible neck imaging.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3668 Questions

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Suggest treatment for stabbing pain in the head while on Gabapentin

Brief Answer: Doesn't look like a trigeminal neuralgia. Detailed Answer: I read your question carefully and I understand your concern. I must say that I agree with you that that type of pain doesn't sound typical for trigeminal neuralgia. Trigeminal neuralgia is typically a facial pain as the face is the territory covered by the trigeminal nerve. It may radiate somewhat to other locations but not be only there. Even the previous pain you describe (originating from the back of the head) doesn't sound like typical trigeminal neuralgia, more like occipital neuralgia (doesn't change treatment much though). This neck pain sounds even less like trigeminal neuralgia. On the other hand I do not think it to be indicative of a dangerous condition so you do not have to overworry. Might be a flare up of fibromyalgia or may be an neck arthritis related pain (I would try if nonsteroid antiinflammatory medication like Ibuprofen has any effect). If the pain persists though another visit might be indicated and possible neck imaging. I remain at your disposal for other questions.