Unilateral Facial Pain (Right Side). Killer Pain!

[Bedge]

Hello, I am new!

I am a 28 year old Female from Sydney, Australia. G'day! ha!

I will apologise in an advance as I fear this will be a long message. I appreciate you time!

Long story short: about 10 years ago I started to experience scary and disturbing feelings. The whole world would feel real or fake, like in a dream. Sometimes I would feel very tall or very short. I couldn't respond properly to people or things, I would kinda 'check out'. My skin would feel grimy and dirty, I would get heat rush up from the souls of my feet, I would get a short ring in my ears ... it was all very bizarre and scary. After 10 years of suffering and being treated like poo from most Dr's - we figured out it was some strange form of Migraine Variant. I am now treated on Sandiomigran and Cipramil (for some reason that combo just works!) and doing well in that respect. There has never been any pain associated with this issue.

Over the last four months I have started to experience horrific pain on the right side of my face. It is behind my eye, in my jaw / teeth, deep in my ear and sometimes in my throat. Sometimes my nose will also feel as if it is broken. The pain scale can be from a 0 and go up to a 10 and beyond. Most days I can feel little twinges in the described areas here and there that will last a second or two. Sometimes it can continue in to horrific long lasting pain involving all the areas at the same time. I would describe the pain as not throbbing, when it is at its worst its a constant boring pain with additional jabs, there is also a scene of pressure. During the throws of intense pain, if I touch any of the areas effected it doesn't create any more pain or similar. I dont seem to have any inflammation in my gums or teeth.

I am unsure if over the counter medications help. There have been a few times that I have reached for them and by that time the pain has completely vanished in a second.

Im under a Neuros care. He was suspect of my neck and asked me to see a Physio. The physio says there is a small chance the pain is coming from my neck as I do have two joints at the base of my skull which are a bit tight. The physio will continue to treat those two joints and will communicate with my Neuro. My MRI showed up clear. I also have Pulsital Tinnitus in my right ear. Im not sure if it is connected or not. I am also left handed.

I am after a fresh opinion. Your suggestions and comments are greatly appreciated.

Thank you.

[MG (Admin)]

How long does the pain last?
What time of the day does it happen usually?
do you ever get a blocked nose, red eye, droopy eyelid when the pain comes?
Looking forward to hearing back,

[Bedge]

Hello!

The pain can last any where from 5 minutes to an hour or two. The longer it lasts, generally the worse the pain is. During the course of the day I can have mini jibs and jabs in the effected areas.

It used to only seem to start at night time, although recently it has been starting earlier.

I don't get a red eye, droopy eye lid or blocked nose. Although, after a particularly bad few nights, a few weeks ago - I did notice that my right eye lid had dropped just a little. That was more in the aftermath though, not during the attack.

Thanks!

[MG (Admin)]

It used to only seem to start at night time, although recently it has been starting earlier.

It is important to know....was there a tendency for it to recur at roughly 24 hour intervals " like clockwork"??

[Bedge]

No, I dont believe it to be clusters - as it comes at strange times. It started off only coming in the afternoons or night time, but it has since changed.

I have just be in hospital with it since Monday afternoon. They put it down to Migraines, although I dont know if I agree.

We did a CT and found one very very strange finding, although my Neuro doesnt believe it is related to my pain.

Check out the CT image!!!!

[MG (Admin)]

Do you have the official report of the CT?

[Bedge]

Hi,

I just got it. It says ....

"A very large right facial venous branch drains into the mid cervical right IJ vein and is continuous with a large venous tributaries along the soft tissues of the nose and medial aspects of the orbits, more pronounced on the right.

The superior ophthalmic veins are not markedly dilated and there is no early opacification of the cavernous sinus to suggest a carotico-cavernous fistula. No aberrant arteriovenous communication is identified.

No glomus tumor identified. Large right facial vein communicating with the periorbital venous tributaries of uncertain aetiology.

[MG (Admin)]

Do you ever get swelling in that area?

[Bedge]

Not that I am aware of.

It defiantly is the side where I get the pain though, none of my Dr's think its connected in anyway.

[MG (Admin)]

What do they think is causing it?

[Bedge]

Migraine. I do not agree ... at all. I am already on migraine abortive medications.

[MG (Admin)]

Please clarify..the pain is in your face or head?

[Bedge]

The pain is in my face. Usually the right side, but I have felt it moving over to the left eye in the last week or so.

I swear it's something to do with my ear. I have seen 3 ENT's, and they say my ear looks fine - which it is. Although it always feels full, I get popping / clicking noises, I have a constant need to hold my nose and blow air through it (not that it does much), and I get stabby pain in what feels like the ear drum.

Thats basically what started off all the pain anyway. A small ear infection, that wasn't really treated properly. Its gone down hill since then, even though the infection as cleaned up.

I constantly feel awful. Every day. I tried to go to work today, although the pain spread behind my right eye, and my eyelid even went a bit puffy. I know that 'sounds' like migraine, but it really truly isn't!

I haven't had the horrific killer murderous pain, for about a week. But I have just been getting the usual jibs and jabs.

No one can I figure it out. I have seen two Physios, 3 Neuros, 2 ENT's and an Osteopath (I know most Neuros dont agree with 'manipulations'!). My Osteopath is quite a clever dude, and he is going to go and meet with my GP tomorrow to discuss me.

I just need some help! Any ideas? Anything? At all??? lol

[MG (Admin)]

Although not totally typical, I would speak to your neurologist about the possibility of trying treatments that work for the cluster-headache related group of headaches.
This could include sumatriptan, oxygen during an attack or indomenthacin.
Preventative treatment with the durgs we use for cluster headache prevention may very well help you too.

Let us know how it goes and whether any of these methods are tried.

all the best

[surgerystudies]

I'm not a physician but were you evaluated for right-sided trigeminal neuralgia? Did anyone ever try putting you on Amitriptyline?