Brief Answer:
Detailed Evaluation needed

Detailed Answer:
Hi, thanks for posting the concern in the HCM.
My understanding is CT scan of brain and CNS have ruled out possibilities of sinusitis, any space occupying lesion, like tumour, lymphoma etc, CVA. Obviously very small ischaemic lesion of the brain cannot be ruled out by CT scan and MRI would have been a better option for the same. Regarding trigeminal neuralgia I can say that I haven't seen a single patient or read a single case report mentioning such problem to have been diagnosed as a case of trigeminal neuralgia. Rather, the symptoms may be due to Bell's palsy.

The later disease doesn't have a specific test for confirmation. Clinical signs are very important in this regard. Therefore, you should consult a neurologist as early as possible for clinical evaluation.
Secondly, you need to do a battery of tests-
Complete blood count, ESR, fasting TSH, HbA1c,HIV ELISA, VDRL.
Some forms of vasculitis often present like this. So, measurement of Antineutrophil cytoplasmic antibody level measurement may be needed.
Often, blockage of Nasolacrimal duct presents similarly. Evaluation by an ENT specialist may also be needed to find out whether there is any abnormality related to the NLD.
Conduction testing and EMG may be required for further evaluation.
As you are a vegetarian, chances of B12 deficiency should also be excluded.
Last but not the least, the functional cause and sleep deprivation should be ruled out too.
For the time being you may follow the below mentioned advices-
1. Home made high fibre diet, also rich in green leafy vegetables.
2. Plenty of oral fluid.
3. Cap Bevon CD one cap once daily for one month.
4. Regular exercise or yoga or walking if possible.
5. Steam Inhalation twice daily for 7 days.
6. Relaxation session and maintenance of regular sleep time.
If you are satisfied with the answer, please close the thread and rate my answer.
Regards.

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Brief Answer:
B12 injection not needed

Detailed Answer:
Thanks Dr. XXXXXXX , for posting the query.
I don't think B12 injection is needed. Only supplementation with Bevon CD can suffice. Her Hb level is OK, so is the MCV.

Please consult a neurologist and an ENT surgeon at the earliest. If it's Bell's palsy early diagnosis and prompt treatment is needed to avoid disabling complications.
For any further information, please write back.
If you find this answer helpful, please close the thread and rate my answer.
Regards,
Dr Kaushik Sarkar

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Brief Answer:
thank you

Detailed Answer:
Thanks Dr. XXXXXXX for the information. It is wonderful to hear from people like you who don't delay in seeking treatment. I can promise you, with prompt treatment most of the diseases are cured or at least well controlled. And thank you again for your courtesy to inform me. In case you need any further information or help from my end, please feel free to write back. I will try my best to help you out.
Regards,
Dr Kaushik Sarkar

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