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I have a sharp pain behind my left eye, it's been going on…

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I have a sharp...

I have a sharp pain behind my left eye, it's been going on for years but getting worse and worse. It's now tearing and stings. I've been dizzy and lightheaded at times. More and more frequently over the last few weeks. There is pressure in my temples and now a sharp pain at the back of my head. A brain MRI two or three years ago was negative. All sinus CT's have been negative. My bloodwork shows no indication of any inflammatory process. But I'm in pain all day every day.

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

Daily now. No nausea.

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

I've had a lot of dental issues in the past and am concerned maybe it's a dental infection that has spread through my sinuses. About 5 years ago a lesion was found in my gums/ jaw on the left side of my face & I had a small piece of bone & gum tissue removed and they found an infiltrate of unknown etiology. Pathology couldn't determine what it was but I think it was filament from a root canal when I was 14.

Submitted: 29 days ago.Category: Neurology
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Answered in 2 minutes by:
3/23/2018
Neurologist: drphophalia, Other replied 29 days ago
drphophalia
Category: Neurology
Satisfied Customers: 37,783
Experience: Regularly deal with musculoskeletal neurology, spinal issues, bowel and bladder dysfunctions etc.
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Welcome to Just Answer.
Answers here are for education and information.
I will respond shortly with an answer, or further information request.

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Neurologist: drphophalia, Other replied 29 days ago

What did MRI of base of skull, face and mandible show?

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Customer reply replied 29 days ago
They did a brain MRI. Does that cover those areas?
Neurologist: drphophalia, Other replied 29 days ago

No it does not.

I agree with your assessment that your pain is referred pain. This means dental issues causing pain to those organs, which have common nerve supply; which are causing your symptoms.

Also inflammatory markers should be repeated which means; CRP, autoimmune panel and sedimentation rate.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

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Customer reply replied 29 days ago
One last question - I've had a lot of bloodwork recently and my sed rate is always at about 1. Does this rule out an inflammatory process and eliminate the chances that its a dental infection?
Neurologist: drphophalia, Other replied 29 days ago

A low sedimentation rate does not rule out inflammation.

It alone does not have much significance.

It needs to be seen in conjunction with;

a) C-reactive protein

b) Autoimmune panel.

You should also be investigated for polyneuropathy. Investigations advised are;

1) Electromyography/nerve conduction studies (EMG/NCS)

2) MRI (with contrast) of the spine and brain

3) blood glucose, glucose tolerance test and glycosylated hemoglobin

4) serum B12 level with methylmalonic acid (with or without homocysteine),

5) serum protein electrophoresis

6) Anti-nuclear antibody

7) Lyme testing

8) Rheumatoid factor

9) Sjogren's syndrome testing (Anti-Ro, Anti-La Antibodies)

It is privilege assisting you.

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Neurologist: drphophalia, Other replied 29 days ago

You may ask your neurologist to also consider Trigeminal neuralgia for your pain.

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Neurologist: drphophalia, Other replied 29 days ago

Your doctor may start Gabapentin for your symptoms till you are investigated.

Was this information helpful to you? I would be glad to answer any further questions.

It is privilege assisting you.

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drphophalia
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Category: Neurology
Satisfied Customers: 37,783
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Experience: Regularly deal with musculoskeletal neurology, spinal issues, bowel and bladder dysfunctions etc.

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