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What causes recurrent painful sensation over one side of lower face?

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Posted on Sat, 20 Jun 2015
Question: I have sores all over the lower part of my body. Including private area. There it is Herpes ONE which was spread from my lips. This was cultured. So I am positive. Bruises all over my life's, they don't hurt at all. I don't even realize they are there until someone says something about them. For the 2nd time tonight, I went to get in bed and my face felt like it was on FIRE. LIKE INA TRYIANGLE THAT INCLUDED MY NOSE. Have no idea what that was.

I had a car accident about a month ago. Two days later all of the sores started coming up. Very stressful at my house right now.

My wreck was a little over a month ago and thank goodness most of the sores have gone away.

My question is, can bruises that you can't feel and you don't know where they came from, and a face that my question is, can bruises that you can't feel and you don't know where they came from, and a face that includes your nose and your mouth be considered as Neuropothy?
doctor
Answered by Dr. Neeraj Kumar (4 hours later)
Brief Answer:
Bruises are not neuropathy and facial pain may be neuropathy

Detailed Answer:
Hello,
Welcome to health care magic. I have read your previous queries and medication and your current question. You have two problems.

First one is appearance of herpes zoster after a car accident. Herpes zoster is a viral infection which presents in adulthood or elderly age as reactivation of virus. Herpes zoster mostly occurs when body immunity decreases. The causes may be prolonged illness, stress, chronic disease, cancer , diabetes, tuberculosis or steroid use and HIV. The one possibilty in your case may be stress or use of steroid during head injury. The treatment for acute herpes zoster is acyclovir 800 mg five times a day for 7-10 days or valacyclovir 1 gm three times a day for 7 days. For chronic and recurrent reactivation longer course of acyclovir 400 mg tds for 12 months may have to be given.

Another complication is post herpetic neuralgia which usually occurs as severe pain in areas of previous lesion after 3 months . Sometimes pain occurs previous to appearance of herpes lesion. Rarely only pain at site without lesion may be presentation called as herpes zoster sine zoster.
Treatment includes local lignociane , drugs like carbamazepine, oxcarbazepine, pregabalin, gabapentin, opioid.

Less likely reccurrent short lasting painful sensation over one side of lower face may be due to trigeminal neuralgia.

Second problem is of non painful bruises occurring from many years. Such bruises are not neuropathy and are vasculopathy. They occurs due to vasculitis, anticoagulation use, coagulaopathy, vitamin k deficiency, renal and liver disorder. You should consult a dermatologist or general physician for proper evaluation of bruises. It is not neuropathy.

Hope you found the answer useful and satisfying.
Do get back to me for further clarification.
Kindly close the question and rate it if your queries are addressed adequately.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Neeraj Kumar (4 hours later)
The triangular pain/burning feeling on my face is a large concern to me. It is not just on one side it starts at the top of the nose for the point, then goes out and makes a type of triangular shape the goes all the way done to below the mouth. Stopping at about the chin area for th straight across line as the bottom of the triangle. It has happened now 2 times. Twice when I was getting into bed with my husband. (There are severe issues that are extremely stressful right now. Including a move, twin 10 yr old boys w autism, high functioning, he is a teacher and has been hospitalized and is now in partial due to what they are calling a "snap" or "break" the psychiatrist said. ) and, as I am typing this it is happening again. What is this?
doctor
Answered by Dr. Neeraj Kumar (3 hours later)
Brief Answer:
herpetic or stress related or maybe sinusitis

Detailed Answer:
Hello kethykemper,
According to you, your involvement area is triangular are over nose and base on chin with midline bilateral distribution.
Herpetic lesions are usually unilateral but on face it may cross the midline to some extent. Other possibility may be some sinus infection leading to maxillary sinusitis. One more possibility of stress related sensory paresthesia may be there.
You need not to worry.
Be watchful for any skin lesions and in that case consult a dermatologist or neurologist.
For treatment you can try amitryptiline, pregabalin or carbamazepine.
Hope you recover early. May God bless you good health.
Wishing you and your family good health.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Neeraj Kumar (3 hours later)
Its very odd in that the face does not turn red, there are no lesions and it is not painful under the skin. It is justthe top layer of the skin. Literally like a sunburn. What would that or could that be, now that you have a bit more information .
doctor
Answered by Dr. Neeraj Kumar (38 minutes later)
Brief Answer:
Nothing serious , consult an ENT specialist or a neurologist

Detailed Answer:
Hello XXXX,

As per your narration with no visible changes of inflammation and skin lesions the condition seems to be of benign nature. I will advice you to try amitriptyline for some time with local lignocaine ointment. If not relieved then consult an ENT specialist or a neurologist who can examine you properly and advise accordingly.
Please do get back to me for further clarification.
Regards
Dr Neeraj Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Neeraj Kumar (3 days later)
Is that an over the counter ointment?
doctor
Answered by Dr. Neeraj Kumar (11 minutes later)
Brief Answer:
In most places it is over the counter drug

Detailed Answer:
Hello,
Yes in most places local anesthetic agents can be purchased for local pain relief. Additionally diclofenac ointment and some capsicum containing counter irritant can also be tried.
Hope you found the answer helpful.
Wishing you good health.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Dr. Neeraj Kumar

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What causes recurrent painful sensation over one side of lower face?

Brief Answer: Bruises are not neuropathy and facial pain may be neuropathy Detailed Answer: Hello, Welcome to health care magic. I have read your previous queries and medication and your current question. You have two problems. First one is appearance of herpes zoster after a car accident. Herpes zoster is a viral infection which presents in adulthood or elderly age as reactivation of virus. Herpes zoster mostly occurs when body immunity decreases. The causes may be prolonged illness, stress, chronic disease, cancer , diabetes, tuberculosis or steroid use and HIV. The one possibilty in your case may be stress or use of steroid during head injury. The treatment for acute herpes zoster is acyclovir 800 mg five times a day for 7-10 days or valacyclovir 1 gm three times a day for 7 days. For chronic and recurrent reactivation longer course of acyclovir 400 mg tds for 12 months may have to be given. Another complication is post herpetic neuralgia which usually occurs as severe pain in areas of previous lesion after 3 months . Sometimes pain occurs previous to appearance of herpes lesion. Rarely only pain at site without lesion may be presentation called as herpes zoster sine zoster. Treatment includes local lignociane , drugs like carbamazepine, oxcarbazepine, pregabalin, gabapentin, opioid. Less likely reccurrent short lasting painful sensation over one side of lower face may be due to trigeminal neuralgia. Second problem is of non painful bruises occurring from many years. Such bruises are not neuropathy and are vasculopathy. They occurs due to vasculitis, anticoagulation use, coagulaopathy, vitamin k deficiency, renal and liver disorder. You should consult a dermatologist or general physician for proper evaluation of bruises. It is not neuropathy. Hope you found the answer useful and satisfying. Do get back to me for further clarification. Kindly close the question and rate it if your queries are addressed adequately. Regards Dr Neeraj Kumar Neurologist