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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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I was diagnosed with trigeminal neuralgia, fibromyalgia,

Customer Question

I was diagnosed with trigeminal neuralgia, fibromyalgia, diverticulosis and colitis. I was put on Lyrica a month ago and it did nothing for fibro but my TN pain intensified. Off Lyrica and now on Carbamazapine?sp? so far it has not helped the TN at all. My fingers are now twitching...not noticable but sensation of an electric stimulation in both thumbs and some fingers. I know I have irritation in C5 C6 and lower spine from a nerve test...however no one seems to think this could be an issue for tingling/numbness I had earlier in hands and feet. Also dealing with cyst on kidney and kidney stone. Still walking :) I really don't want to take meds to cover symptoms...I really want to find the root of the problem...could something in my neck be the primary cause of TN ? I also have a constant pain and inch or so behind my left ear and slightly up which is annoying and hurts when chewing. My TN is worse when my body has inflammation I have noticed. Any relation between these at all?
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

Hello. Welcome to JA. I will review your statement and send a response shortly. Please review this preliminary answer and reply. We can discuss this topic until you are satisfied. Dr Frank

Expert:  Dr. Frank replied 1 year ago.

In answer to your question, "Any relation between these at all?", the initial response would be probably, I have not seen all your records or examined you, read neurology consults on you, but I can say that is in "classic" trigeminal neuralgia, responses to tegretol (carbamazepine) which has a 40 year history of use, and more recently Lyrica (pregabalin) or Neurontin (gabapentin) are expected at least initially for decreasing the severity of the attack, and the number of exacerbations or attacks you have. In TN, you are expected to have specific triggers for the lancinating facial pain that has to follow a trigeminal nerve distribution, either VI, V2 or V3. Do you have that. TN has been seen in association with fibromyalgia, a poorly understood entitiy of migratory arthralgic pain and myalgic pain with tender points and problems of sleep. In that sense, this is not classical TN. Other diseases to consider include atypical facial pain, TMJ syndrome, or sinusitis related pain syndrome. Reading your comments, all of these seem possible. I can try to send you a better answer, but would need some information like your brain/cervical spine MRI, the results of that EMG test of the upper extremities, etc. Please get back to me with questions/information if you think I can help. Ask specific questions as it is difficult for me to give you a diagnosis here online without an examination face to face. If satisfied with this answer, please remember to rate my service as that is how I am compensated for my work, just click on the rating stars. Dr Frank