Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Pain On Side Of Face
Question: Hi Doctors,
i have pain in my left side of the face(almost every spot ) i did a 3D ct scan for my jaws and teeth, as well as a head and neck and brain MRI but the findings shows Fogginess in same side of the pain, is there a problem if it shows cloudy result?
appreciate your kindly response..
i have pain in my left side of the face(almost every spot ) i did a 3D ct scan for my jaws and teeth, as well as a head and neck and brain MRI but the findings shows Fogginess in same side of the pain, is there a problem if it shows cloudy result?
appreciate your kindly response..
Brief Answer:
Clinical aspect is important to better understand the probable cause
Detailed Answer:
Hello. I have been through your question and understand your concern.
Facial pain has many causes, and I suppose by consulting several doctors you excluded several hypothesis on the cause.
It is very important the characteristics of the pain. Is it continuous? Is there any stimulus which enhances the pain, like eating, teeth brushing, speaking etc? Have you used any treatment so far, and was it effective?
Secondly, it is important the brain MRI. I might find it helpful the full report of the MRI, in order to rule out any neuro vascular conflict, which might be the cause of a resistant, refractory facial pain.
At last a nerve conduction study might be very helpful to understand the conduction of the trigeminal nerve.
Hope this helps.
Best regards.
Geldon Fejzo MD
Clinical aspect is important to better understand the probable cause
Detailed Answer:
Hello. I have been through your question and understand your concern.
Facial pain has many causes, and I suppose by consulting several doctors you excluded several hypothesis on the cause.
It is very important the characteristics of the pain. Is it continuous? Is there any stimulus which enhances the pain, like eating, teeth brushing, speaking etc? Have you used any treatment so far, and was it effective?
Secondly, it is important the brain MRI. I might find it helpful the full report of the MRI, in order to rule out any neuro vascular conflict, which might be the cause of a resistant, refractory facial pain.
At last a nerve conduction study might be very helpful to understand the conduction of the trigeminal nerve.
Hope this helps.
Best regards.
Geldon Fejzo MD
Above answer was peer-reviewed by :
Dr. Shanthi.E
In fact i did brain MRI, doctor told me was good
I have took almost all nerves medicine including acupuncture, in addition to b comblex, vitamins, calsum, tragretol, osteocare, pregadex, neurontin, sapofen, reparil dragees, lyrica, lercadip, no uric, hymox, neurobion, zithromax, relaxon, disprin, celebrex, aerius, nexium, tizanidine sirdalud,
I did also electroencephalogram it was normal
I removed wisdom teeth.
-The most imprtant question is, what dose the fogging means in the ct scan and MRI?
Because the fogging appeared in both ct and MRI
The pain continuose everyday
There is nothing stimulus enhancing the pain
The doctors tested my faicial nerves response they said all fine and been told that i dont have Trigiminal as well as i have no Deformities and no abnormalities nor changing in my face to make me have Trigiminal
I have took almost all nerves medicine including acupuncture, in addition to b comblex, vitamins, calsum, tragretol, osteocare, pregadex, neurontin, sapofen, reparil dragees, lyrica, lercadip, no uric, hymox, neurobion, zithromax, relaxon, disprin, celebrex, aerius, nexium, tizanidine sirdalud,
I did also electroencephalogram it was normal
I removed wisdom teeth.
-The most imprtant question is, what dose the fogging means in the ct scan and MRI?
Because the fogging appeared in both ct and MRI
The pain continuose everyday
There is nothing stimulus enhancing the pain
The doctors tested my faicial nerves response they said all fine and been told that i dont have Trigiminal as well as i have no Deformities and no abnormalities nor changing in my face to make me have Trigiminal
Brief Answer:
you need another MRI in a month time
Detailed Answer:
Hello again. Fogging on CT scan and MRI is a general term used to describe an area of the brain which appears in a different way respect to the surrounding normal brain area.
Generally, the fogging area appears immediately after a brain damage, like stroke, but this is not the rule. Radiologists might need gadolinium injection when doing the MRI to better understand the fogging region of the brain. Still, I do not understand why the radiologist says it is a normal MRI and at the same time says fogging. This should be furtherly cleared.
In your case, the question is: does the fogging area corresponds to your facial pain? Generally the damaged brain cause weakness or numbness in the body, inluding the face, while pain is uncommon.
A specific region of the brain, called thalamus may cause pain, but it includes the body as well.
Basically, I recommend repeating the MRI one month after the last MRI because the supposed damaged area (fogging) will be more clear.
At last a nerve conduction study of the facial nerves might help understand if the triheminal is damaged (even if the neurological exam seems normal, some damage seen in the study should explain the pain)
Hope this helps. Let me know on the further proceedings
you need another MRI in a month time
Detailed Answer:
Hello again. Fogging on CT scan and MRI is a general term used to describe an area of the brain which appears in a different way respect to the surrounding normal brain area.
Generally, the fogging area appears immediately after a brain damage, like stroke, but this is not the rule. Radiologists might need gadolinium injection when doing the MRI to better understand the fogging region of the brain. Still, I do not understand why the radiologist says it is a normal MRI and at the same time says fogging. This should be furtherly cleared.
In your case, the question is: does the fogging area corresponds to your facial pain? Generally the damaged brain cause weakness or numbness in the body, inluding the face, while pain is uncommon.
A specific region of the brain, called thalamus may cause pain, but it includes the body as well.
Basically, I recommend repeating the MRI one month after the last MRI because the supposed damaged area (fogging) will be more clear.
At last a nerve conduction study of the facial nerves might help understand if the triheminal is damaged (even if the neurological exam seems normal, some damage seen in the study should explain the pain)
Hope this helps. Let me know on the further proceedings
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
hello again dear doctor Geldon
actually the time duration between first MRI and second CT was approximately four months (both tests with was with contrast) but the fogging still exist in the both exams, doctors thought maybe i have metallic material in my teeth but i don't have any, and they couldn't identify the problem.
also sometimes i have slight numbness in my tongue and cheek in the same painful side(left),
-three weeks ago i have faced heaviness in my tongue while talking, it stayed for 9 days but it gone now, rarely when i get anger, this heaviness comes to me but with very unnoticeable level.
also i did nerve condition study, it was fine
i am wondering is the Temporomandibular Joint may cause all these symptoms?
also i want to re point out to the pain symptoms as following:
-headache and eye headech.
-massive inner ear pain.
-pain behind the ear (all doctors told me i don't have any ears problem not even middle ear Disease.
-massive brain nerve pain which is just above eyebrow left to up to the brain?
-pain in the joint.
-electrical feeling in the eye, also hot feeling in the eye (i tested my eye Pressure), it was good.
-sometimes i hit my head by my hands, is this cause the fogging?
almost every day i feel like i am not aware of the reality (feels like dreaming)
* all these symptoms just in the left side only.
actually the time duration between first MRI and second CT was approximately four months (both tests with was with contrast) but the fogging still exist in the both exams, doctors thought maybe i have metallic material in my teeth but i don't have any, and they couldn't identify the problem.
also sometimes i have slight numbness in my tongue and cheek in the same painful side(left),
-three weeks ago i have faced heaviness in my tongue while talking, it stayed for 9 days but it gone now, rarely when i get anger, this heaviness comes to me but with very unnoticeable level.
also i did nerve condition study, it was fine
i am wondering is the Temporomandibular Joint may cause all these symptoms?
also i want to re point out to the pain symptoms as following:
-headache and eye headech.
-massive inner ear pain.
-pain behind the ear (all doctors told me i don't have any ears problem not even middle ear Disease.
-massive brain nerve pain which is just above eyebrow left to up to the brain?
-pain in the joint.
-electrical feeling in the eye, also hot feeling in the eye (i tested my eye Pressure), it was good.
-sometimes i hit my head by my hands, is this cause the fogging?
almost every day i feel like i am not aware of the reality (feels like dreaming)
* all these symptoms just in the left side only.
Brief Answer:
another MRI is essential
Detailed Answer:
Hello again.
At this point the problem is focus on 3 matters.
1. The brain fogging which I still recommend another MRI to compare with the first MRI, in order to rule out any progression (CT scan is not appropriate for this purpose) 2. The trigeminal nerve, with the last tongue involvement, we are still in the trigeminal area. 3. Maybe the facial nerve as well with the ear involvement. Basically the ear is a mix area with several cranial nerve involved, but facial nerve as well is included.
At this point you have used all the possible treatments available. So there is no other drug for you to recommend other than those you already have tried so far.
Maybe immunological test may help on exluding those affecting the trigeminal nerve (which might miss in the MRI and nerve conduction study).
But as you see, medicine has limits as well. The important thing is that you have excluded important conditions like tumors (fogging is definitely not a tumor)
At the end I recommend another MRI
Hope this helps.
Wish you the best health.
another MRI is essential
Detailed Answer:
Hello again.
At this point the problem is focus on 3 matters.
1. The brain fogging which I still recommend another MRI to compare with the first MRI, in order to rule out any progression (CT scan is not appropriate for this purpose) 2. The trigeminal nerve, with the last tongue involvement, we are still in the trigeminal area. 3. Maybe the facial nerve as well with the ear involvement. Basically the ear is a mix area with several cranial nerve involved, but facial nerve as well is included.
At this point you have used all the possible treatments available. So there is no other drug for you to recommend other than those you already have tried so far.
Maybe immunological test may help on exluding those affecting the trigeminal nerve (which might miss in the MRI and nerve conduction study).
But as you see, medicine has limits as well. The important thing is that you have excluded important conditions like tumors (fogging is definitely not a tumor)
At the end I recommend another MRI
Hope this helps.
Wish you the best health.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hello again doctor
Okay I will do another MRI, But i have some qustions doctor
1-what if the fogging appear only in the jaw(cheek) What is cuase might be then?
2-Is the allergy cause all aforementioned pain ?
3-once i sneez these pain come and strongly increased, in addition to some itchy sensation in my throat?
-is back problems may cause all these pain
Okay I will do another MRI, But i have some qustions doctor
1-what if the fogging appear only in the jaw(cheek) What is cuase might be then?
2-Is the allergy cause all aforementioned pain ?
3-once i sneez these pain come and strongly increased, in addition to some itchy sensation in my throat?
-is back problems may cause all these pain
Brief Answer:
MRI reccomended
Detailed Answer:
Hello.
1. The fogging may be permanent and not related to your symptoms. So, it is important to be sure the fogging is stable, even in the jaw. But the cause is not easy to define by mri or ct scan. It could be a banal wrong signal deformed by tooth treatment other than metal.
2. Allergy is less likely to be the cause, because generally it is associated with itching sensation, not pian.
3. This leads to a probable inflammation in your throat, which explains itching but not exactly the pain, unless it is in the area where trigeminal nerve passes.
Back is definitely not involved in these type of symptoms.
Basically I still recommend a contrast enhanced MRI, to better see the area of the throat.
Best regards
MRI reccomended
Detailed Answer:
Hello.
1. The fogging may be permanent and not related to your symptoms. So, it is important to be sure the fogging is stable, even in the jaw. But the cause is not easy to define by mri or ct scan. It could be a banal wrong signal deformed by tooth treatment other than metal.
2. Allergy is less likely to be the cause, because generally it is associated with itching sensation, not pian.
3. This leads to a probable inflammation in your throat, which explains itching but not exactly the pain, unless it is in the area where trigeminal nerve passes.
Back is definitely not involved in these type of symptoms.
Basically I still recommend a contrast enhanced MRI, to better see the area of the throat.
Best regards
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
