[Sorry this is rather long and I don’t want to keep doctor dopers reading my whiny story, so I’ve highlighted what I think is essential information and the actual questions in bold. ]
I feel like I’ve asked this before, but I think I just started to type it up several times and never finished seeing as how I can’t find it, nor do I remember an answer. I’ve been working a lot so my memory is next to useless at this moment. Sorry if this is a dupe.
When I was a kid living in Russia, about thirteen years ago, I developed a rather strange headache. I had a persistent dull yet severe pain over my left eyebrow (strangely enough there’s a chance it was right, not left, I just can’t quite recall) that would occasionally turn into a piercing blinding stabbing flash of agony. The stabbing aspect of it was the most painful thing I have ever experienced before or since. The major problem was that it did not go away – not even for a minute. I was very very sensitive to light and it made the pain a lot worse. After a couple of days my mom decided that this wasn’t right, and took me to a doctor. The doctor shrugged her shoulders and said “sounds like a migraine, take some analgin” (Sodium metamizole, OTC in Russia) and that was that. Well, that WOULD BE that, except analgin didn’t help. Aspirin didn’t help. Nothing fucking helped. The only thing that made the pain less is if I pressed my face into my forearm, partially to provide pressure, but mostly to block out all light. Maybe after a week of this after visiting the first doctor my mom decided it was time for a second opinion (which isn’t an easy thing to come by with socialized health care, but I digress). The second doctor was a little more concerned, since it’s been close to ten days since it started and my eyes started watering and just would not stop – I wasn’t crying… I was leaking. This doctor also didn’t do anything but I am a little hazy on the details as to why (I’ve spent a lot of time repressing this period of my life), but at least the words “trigeminal neuralgia” (Russian: “восполение тройничного нерва”, literally inflammation of the trigeminal nerve – is that the same as “trigeminal neuralgia”?) were uttered. Time passed, and the pain was spreading across my face. Finally somehow we got referred to a surgeon(or something… somebody… ) for a consult and two months into this situation I got to see somebody who instead of thinking of what particular “not-my-problem department” to send us to started thinking as to what can be done. Russian doctors, in my experience, aren’t big on making smalltalk or explaining to patients what they do, especially to children(considered too dumb) or parents(considered dumber), so this is why even my mom doesn’t have any useful information about this.
She mentioned the trigeminal nerve and inflammation and something about not being physical causes since I did not experience any trauma (I did not, I woke up with this one day). Then she said there’s something she wants to try and it’s not necessarily pleasant (although she didn’t mention anything about it being unsafe) – I don’t like it when doctors say “There’s something they want to try” and it’s a separate sentence from what it is they want to try, but at that point I just didn’t fucking care. Frankly, a guillotine sounded like the perfect solution to me at that point.
What she tried was an injection right at the site of the pain – right through the eyebrow into the whatever nerve is there. Now I’m fairly clear on this part, because having a huge fucking injection done to your face is not something you easily forget. She said injection contained Novocaine, and asked my mom if I was allergic but really didn’t specify if it had anything else in it, or what it was supposed to do. I knew Novocaine was a powerful painkiller and she mentioned she’s never seen a child be so eager to get a shot in a nerve before. Well, I got a shot to my face, and my entire damn forehead went numb and … the pain… it was gone… within minutes… completely!
She said that when the Novocaine wears off there’s a chance the pain will not return. If it does, we have to come back and discuss long term treatment options, if it does not, come back when and if it does. She said the** likelihood of it coming back **at some point of my life if it didn’t come back immediately was pretty high. I didn’t care – the pain was gone, even if for a sweet delightful minute. My face was numb, and if it had to be numb forever then so be it! It did not come back since, and when the Novocaine wore off normal sensation returned just without the pain… yet any time I get a headache I think about it with terror.
When I was a teenager in the US I looked all this stuff up on the net because I was curious. I found out about atypical trigeminal neuralgia, surgical intervention, matching symptoms, matching translated descriptions and it just all lined up nicely. It all lined up nicely then.
Now I was curious for more information since medicine just tickles my nerd reflexes . I started reading and reading and reading. Something just doesn’t add up. I keep looking at anatomy charts, and treatment descriptions and I can’t keep it coherent in my head.
**If I had atypical trigeminal neralgia why was a Novocaine nerve block attempted? ** This doesn’t seem standard procedure. Nor does it seem particularly safe.
Why did it work? It seems sometimes it’s done as a first step in several different treatments. Nothing else was done. What mechanism would keep the pain from re-occurring for thirteen years and counting?
What nerve was it? I can’t seem to find any major nerves going through the eyebrow, but I am not really good at finding things like that. If it really was some end of the fifth nerve, then is it standard to attempt a nerve block at the site of pain rather than then in the thicker part of the nerve (which can’t be accessed through the eyebrow I presume)
Was that really just a Novocaine shot or is there more to it I don’t remember? It seems some time ago neuralgia was often treated by a Novocaine block and then an alcohol shot to kill part of the nerve causing pain. I only got one shot, but it was big. Bigger than any immunization or any other shot I’ve gotten up to that point in my life. Maybe it’s because it was up close to my face, I don’t know. I left afterwards and there was no follow-up. I am, however, good at repressing things. I’ve fairly certain I didn’t have any surgery, but could what I described have been it?
Was it really a Novocaine nerve block? I went numb. I’m almost certain a local anesthetic was involved. This was the first time I’ve gotten any kind of local anesthetic and it’s been unmistakably same since. The lidocaine shots at the dentist all have roughly the same feeling, except my forehead went really really numb until the next morning or so.
Most importantly, do I have enough information to have this procedure attempted again if this reoccurs? I have a fear, perhaps an irrational fear, that this will hit me some day again and I’ll have to swallow anticonvulsants and go under the knife when all I need is another novocaine shot to the head – all because no doctor in the US is going to attempt something like that. Does that sound risky? What if it reoccurs in some other part of my face (could that happen? I feel like it could, but I’m not sure what I’m basing this on)?
Any theories if this could’ve had a cause or was it just one of those causeless thingies?
Thank you very much, and sorry about the length (or potential dupe).
- Groman