Unexplained headache
Dr.
Jiang: Hello! A couple of days ago at work, I experienced a sharp, electric-like pain located about 2 to 3 centimeters above my left eyebrow.
The pain comes and goes, and it has persisted for two and a half days.
The location of the pain has shifted from 2 centimeters above my left eye to my left ear.
Over the past few days, the last molar on the left side of my lower jaw has shown significant sensitivity to hot and cold stimuli.
The gums are not swollen, and there is no pain in the tooth itself, but I do experience sensitivity when eating.
I also have a history of nasal allergies, for which I take medication only during flare-ups.
Last week, I had some mild allergy symptoms, including sensitivity and frequent sneezing, and I took Loratadine and a nasal spray, but they were not very effective in suppressing the symptoms.
I have been taking medication every two days to manage these mild allergy symptoms.
Could you please advise me on what might be causing this headache? Is there anything I should be particularly concerned about? Thank you!
Xiao Wu, 40~49 year old female. Ask Date: 2021/08/28
Dr. Jiang Junyi reply Neurology
Dear Mr.
Wu,
Regarding the symptoms you mentioned, if dental issues are ruled out, it may be necessary to consider trigeminal neuralgia.
According to the International Classification of Headache Disorders, Third Edition (ICHD-3), the diagnostic criteria for trigeminal neuralgia are as follows:
- At least three episodes of pain
- Pain occurring in one or more branches of the trigeminal nerve
- At least three of the following characteristics of the pain:
- Duration of a few seconds to two minutes, with periodic, paroxysmal attacks
- Severe intensity of pain
- Electric shock-like, burning, or sharp pain
- More than three trigger points on the face
- No other obvious clinical neurological deficits
When there is a relevant medical history and symptoms that meet the above criteria, a physician will diagnose through appropriate examinations and provide suitable treatment.
Unlike other types of pain, anti-inflammatory and analgesic medications are not very effective for trigeminal neuralgia.
The primary treatment for trigeminal neuralgia is with anticonvulsant medications.
I recommend that you seek evaluation and treatment from a neurologist.
Please ensure to practice self-protection, maintain cleanliness and disinfection, and adhere to new preventive measures before and after your medical visit.
Thank you for your inquiry, and feel free to discuss any related questions further!
Wishing you good health, peace, and joy.
Dr.
Jiang Junyi, Taoyuan Medical Center
Reply Date: 2021/08/28
More Info
Understanding the causes of mysterious headaches can be quite complex, as headaches can arise from a multitude of factors, including tension, sinus issues, dental problems, and even neurological conditions. Based on your description, it seems you are experiencing a specific type of headache that is accompanied by sensitivity in your teeth and nasal allergy symptoms.
The pain you describe, particularly the sharp, electric-like sensations around your left eyebrow and its subsequent movement towards your left ear, could potentially be indicative of a few different conditions. One possibility is a type of headache known as a "trigeminal neuralgia," which is characterized by sudden, severe facial pain that can be triggered by activities such as eating or touching the face. This condition is associated with the trigeminal nerve, which is responsible for sensation in the face and motor functions such as biting and chewing.
Another possibility is that your headache could be related to sinus issues, especially since you mentioned having nasal allergies. Sinus headaches typically occur when the sinuses become inflamed or congested, leading to pressure and pain in the forehead, cheeks, and around the eyes. Given your history of nasal allergies and the recent mild symptoms, it’s plausible that sinus pressure could be contributing to your headache.
Additionally, the sensitivity in your upper left molar could suggest a dental issue, such as a cavity or gum disease, which might also be causing referred pain that you perceive as a headache. Dental problems can often manifest as headaches, particularly if there is an infection or inflammation in the gums or teeth.
Given these possibilities, it is important to consider a few steps moving forward:
1. Consult a Healthcare Professional: Since your symptoms have persisted for several days, it would be advisable to consult with a healthcare professional, such as a neurologist or an ENT specialist. They can perform a thorough examination and may recommend imaging studies, such as an MRI or CT scan, to rule out any serious underlying conditions.
2. Dental Evaluation: It would also be wise to see a dentist to evaluate the sensitivity in your molar. They can check for cavities, gum disease, or other dental issues that may be contributing to your symptoms.
3. Manage Allergies: Since you have a history of nasal allergies, managing these symptoms may help alleviate some of your headache pain. Consider discussing with your doctor the possibility of adjusting your allergy medications or exploring other treatment options.
4. Monitor Symptoms: Keep a diary of your headache occurrences, noting the intensity, duration, and any associated symptoms. This information can be valuable for your healthcare provider in diagnosing the issue.
5. Lifestyle Adjustments: Stress management techniques, regular exercise, and maintaining good hydration can also help reduce the frequency and severity of headaches.
In conclusion, while your symptoms may be related to tension or sinus issues, the combination of facial pain and dental sensitivity warrants a comprehensive evaluation to determine the exact cause. Early intervention can lead to more effective management and relief from your symptoms. Please take care and seek medical attention as needed.
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