Brief Answer: Migraine/Trigeminal Neuralgia= other possibilities Detailed Answer: Hi there, Thanks for your query. TMJ pain often radiates to the temple of the same side, which can account for the occasional sharp pains felt in the temple region. However, given the history of feeling of pulsations with associated temporal pain, it can be a case of atypical migraine or even a cluster headache. Some of the anti-hypertensive drugs (particularly beta-blockers such as propanolol, metoprolol or verapamil) are effective as prophylactic treatment of migraine and cluster headache. Perhaps, you may have been on one of these drugs for hypertension, which had kept migraine under control; its withdrawal may have precipitated migraine. Migraine requires 6-12 months of prophylactic treatment with combination of anti-depressants, beta-blockers and anti-anxiety drugs. Yet another condition, called Trigeminal Neuralgia (inflammation of the nerve which conducts pain sensation from one half of the face) present in the similar manner along with symptoms of TMJ (shooting, sharp or electrical shock type pains, in the region extending from temple, up to the TM joint or, even up to angle of the mouth). It is therefore possible that Trigeminal Neuralgia was mistaken as a TMJ problem. Regular use of certain anti-epileptic drugs(such as, carbamezapine or gabapentin) are very effective in relieving the symptoms. I therefore strongly recommend that you discuss my opinion with your treating doctor, who- I am sure- will concur with me. He will explore these alternative possibilities and- if confirmed- will modify your prescription accordingly. Hope you find my response helpful, informative and logical. Do not hesitate in reverting back to me in the event of further clarifications, if any. Dr. Rakesh Karanwal

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