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I went to doc asst today thinking i had a bad allergy to…

Customer Question
I went to doc...

I went to doc asst today thinking i had a bad allergy to something. Last eve my top front teeth hurt. Then felt swelling beginning above top lip andbottom of nose but below skin. Sore to touch. Took tylenol before bed and slept okay. This morning more swelling. Sore to scrunch up nose. Went to doc. Nose inside is swollen. Like a cold but I don’t have a cold. Nothing done or given. Told to take zyrtec or Claritin for a few days. Also headache. Hx of a precancerous spot on nose, had surgery with 15 stitches to get it all. This soreness and swelling is on same side of nose. My left side. Took Claritin which alleviated stuffiness but soreness and achiness still there.

Doctor's Assistant: Is the headache episodic or daily? And what about nausea?

I have hx of migraine but in my later years i only get some symptoms. Earlier today location was bac bottom of head and above eyes. Tonite pressure on top of head and behind eyes. I also have hx of anxiety for which i take Effexor. At some times during the day I have had a little sick feeling but nothing bad.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I have increased bp and increased cholesterol and diabetes all family related and for which i am on meds.

Submitted: 7 months ago.Category: Neurology
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Answered in 7 minutes by:
12/15/2017
Neurologist: Dr. Bob, Neurologist (MD) replied 7 months ago
Dr. Bob
Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5,762
Experience: Neurology & Int Medicine (US Trained): 20 yrs experience
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Hello. Have you noticed any redness or rash in the painful area? Is the pain only on one side, or both?

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Customer reply replied 7 months ago
No refness or rash. Soreness one sided. I did recently have tmj on that same side abd had been doung renovating in an older home. Thought it could be sinus related. Face is only really sore above lip to nose and lower to side of nose. To touch but aches too.
Customer reply replied 7 months ago
Make that redness.
Neurologist: Dr. Bob, Neurologist (MD) replied 7 months ago

There are a couple of viruses that can come out along the tiny branches of the trigeminal nerve and cause painful swelling near the upper lip and nose. One is the herpes simplex virus that also causes cold sores, the other is the herpes zoster virus that causes shingles. In this unusual areas, there may not be the typical rash or cold sores. The treatment is acyclovir, which suppresses the viral replication.

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Customer reply replied 7 months ago
I have had the shingles shot and i never get coldsores. I am 74.
Customer reply replied 7 months ago
Is this a final dx from you? So not sinus related?
Neurologist: Dr. Bob, Neurologist (MD) replied 7 months ago

There aren't too many other things that come up like this and cause soreness and swelling. The shingles shot is pretty protective but doesn't stop all cases (makes some cases lighter or less severe). Herpes doesn't always cause cold sores. In can even cause meningitis, without any cold sores. A sinus infection would be possible as the floor of the sinus shares the same nerves as the upper teeth. However, there is usually nasal congestion, nasal discharge, foul breath, etc. If you suspected this you would need to go on antibiotics and decongestants.

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Customer reply replied 7 months ago
Then if i can make it thru the weekend , i will reconnect with my doc or call on weekend or go to e.r. It is very uncomfortable. Thank you for your time and expertise.
Neurologist: Dr. Bob, Neurologist (MD) replied 7 months ago

You're welcome. When the nerves are infected or inflammed, it can really hurt, but is not an emergency. Hope all works out for the best for you.

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Neurologist: Dr. Bob, Neurologist (MD) replied 7 months ago

Hi there. How is your pain today? Were you evaluated? Let me know if you have any follow up questions. I would be happy to help further.

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