Background :Around 2 years back burning sensation in the gums and right cheek started. During this period a lot of dental work was done including extraction of the wisdom teeth and the RCT’s of the molar teeth mainly on the right side. An implant was also placed in the right side. All this dental work did not bring any relief and all this burning converted into pain within 6-7 months. Current Primary symptoms/ Pain Areas:      Pain in right upper jaw of the face; pain sensation is felt in all the teeth of upper right. (Refer encl. Photo “face”).      Pain in right lower jaw of the face; pain sensation is felt in all the teeth of lower right. (Refer encl. Photo “face”). Frequency ,type & duration:      Continuous (24 x 7) and throbbing blunt pain – medium intensity ( past 1 ½ yrs)- feeling of heaviness      High intensity spikes in pain – twice or thrice a fortnight( past 1 ½ yrs) Other observations: The patient is not able to sleep on his right side as it aggravates the pain when he gets up in the morning. Consequently for the past two years he has to sleep either on his left side or on his back with face up. The pain also aggravates during office hours especially when he has to do lot of talking. Because of the above problem, the patient is also suffering from high blood pressure and has to take medication to control it. The intensity of pain has gradually increased over past 1 ½ yrs) Contrast MRI report of the brain has been done which does not have any negative observation is attached for your ready reference. Current Secondary symptoms/ Pain Areas:      Pain on the right side of the neck (refer encl.Photo “neck”)- feeling of stiffness      Pain from neck is extending upto right shoulder (refer encl.Photo “shoulder”)      Some times the pain is extending upto right eye and right portion of temple Frequency ,type & duration:      Continuous , throbbing pain (past 4~5 months only) Past Medication: Initially the patient was put on Tegrital 200mg (i.e 1 ½ years back).The dose has increased gradually with the increase in pain. Current medication status      Morning dose - Amtas AT25 (Blood pr)      Morning dose – 200mg Tegrital and Neugaba 150      Night dose - 100mg Tegrital and Neugaba  150
Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concern...As per your complain and presentation of symptoms and the course of pain and the aggravating factors that cause the increase in pain clearly indicates that you are suffering from TRIGEMINAL NEURALGIA which is caused due to either compression of the trigeminal nerve by any large artery or a tumour or cyst or due to physical trauma to the nerve by some blow or accident or due to dental procedure..The nerve compression or injury can lead to electric shock like pain in the course of trigeminal nerve which is fifth cranial nerve and provides sensations to face..The pain can aggravate due to talking, chewing, shaving, touching the affected side of face, or even affecting the affected side of face..The medication that you are taking like TERGETROL [CARBAMAZIPINE] is first line medicine and is given to control pain in trigeminal neuralgia..Neugaba is a second line drug used to control neuralgic pain..As the pain is not being controlled you should consult a NEUROPHYSICIAN and get evaluated and he can advise you to get an MRI SCAN done so that he can evaluate the course of the trigeminal nerve and find out the cause of pain and if medicines do not work a Surgical approach can be made..MICROVASCULAR DECOMPRESSION, GAMA KNIFE RADIOSURGERY OR BALLOON DECOMPRESSION are a few procedures that can be done to relieve pain in Trigeminal Neuralgia patients and the procedure can be decided depending upon the cause..Hope this information helps..Thanks and regards..Dr.Honey Nandwani Arora..