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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 9000
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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My family physician diagnosed my face, ear and scalp pain as

Customer Question

My family physician diagnosed my face, ear and scalp pain as trimenigal neuralgia without doing an MRI. I asked if I needed one, which I feel I do and would feel better if I had a mri, but he said not necessary. Should I feel comfortable not having a mri without worrying if I have a tumor or the start of MS
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

Hello. Welcome to JA. I will review your statement and reply shortly. Please read this preliminary answer and respond. Dr Frank

Expert:  Dr. Frank replied 1 year ago.

As a neurologist, you could determine if it was "pure" trigeminal neuralgia by a careful clinical history and neurological /physical examination. In the old days, that worked great. But in today's modern Neurology, I would tend to agree with you, that you should have an MRI with attention to the mid pons/brainstem and course the trigeminal nerve through its pathway in the skull to exclude benign tumors like meningiomas, or acoustic neuromas that are known to cause this problem. There are better medications for trigeminal neuralgia than advil, or course. Some are metabolized by the kidney, instead of the Liver, which would be ones you could consider for use. Probably the most efficacious drug for treating Trigeminal Neuralgia that is not metabolized at all, excreted unchanged in the kidneys is Pregabalin (Lyrica). So I would consider asking your PCP for a prescription for lyrica as a trial. The initial starting dose is 75 mg twice a day, for you as a woman, you might want to start out with 50 mg two to three times a day (150 mg a day) and then work up to 300 mg a day over a few weeks. Please get back to me to discuss this further if I can help. Or if satisfied, please remember to rate my service by clicking on the rating stars, as that is how I am compensated for this work thanks *****