Daijiworld Media Network - Mumbai
Mumbai, Oct 21: Persistent facial pain that continues despite dental treatment, sinus medication or painkillers may sometimes be caused by nerve disorders rather than problems with the teeth or sinuses, according to Dr Jaydev Panchawagh, Senior Consultant Neurosurgeon at Sahyadri Super Speciality Hospital.
Three conditions that can cause distinct patterns of pain are trigeminal neuralgia, glossopharyngeal neuralgia and occipital neuralgia. Although they affect different nerves and parts of the body, their symptoms can resemble common dental, ear or headache-related conditions, making diagnosis difficult.
Trigeminal neuralgia affects the nerve responsible for carrying sensations from most parts of the face. Irritation or compression of the nerve, often by a blood vessel inside the skull, can cause sudden, intense, electric shock-like pain on one side of the face.
Routine activities such as brushing teeth, chewing, speaking or even exposure to a breeze may trigger an attack. Since the pain can occur in the cheek, jaw or teeth, patients may initially seek dental treatment.
Glossopharyngeal neuralgia is a rarer condition that causes sharp pain deep in the throat, at the root of the tongue or inside the ear. Swallowing, coughing, yawning and speaking can trigger episodes. As the symptoms may resemble tonsillitis or an ear infection, the underlying nerve condition can sometimes go unrecognised.
Occipital neuralgia affects nerves originating in the upper neck and typically causes pain at the back of the head that may spread across the scalp and towards the ear or eye. The pain can be sharp, burning or throbbing and may be mistaken for migraine. Neck-related problems can also contribute to the condition.
According to Dr Panchawagh, sudden and severe pain attacks, discomfort triggered by routine activities and recurring pain that follows the same path on one side of the body are important signs that warrant medical evaluation.
Maintaining a record of pain episodes, including their duration, location and possible triggers, can help doctors assess the symptoms and identify the underlying cause.
Treatment generally begins with medicines that help calm overactive nerves. These medications differ from ordinary painkillers and should be taken under medical supervision.
For occipital neuralgia, treatment may include nerve blocks, physiotherapy and management of underlying neck problems. In cases of trigeminal and glossopharyngeal neuralgia where medication fails to provide adequate relief or causes difficult side effects, microvascular decompression surgery may be considered.
The procedure aims to relieve pressure on the affected nerve when a blood vessel is responsible for the compression. After identifying the problem through specialised MRI imaging, the surgeon makes a small opening behind the ear and moves the blood vessel away from the nerve, leaving the nerve intact.
Dr Panchawagh emphasised the importance of recognising the symptoms and seeking appropriate medical assessment, as persistent nerve pain can interfere with everyday activities such as eating, speaking and sleeping.
However, facial pain accompanied by facial weakness, slurred speech, sudden vision loss, a severe sudden headache, dizziness or weakness in an arm or leg requires immediate emergency medical attention, as these symptoms may indicate a serious condition rather than neuralgia.