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    Dr. P PLEASE
    ValarieW77 posted:
    Hello Dr.

    I wanted to ask you if you can give any advice into Trigeminal Neuralgia .

    I know this can be found in people with Fibromyalgia and also MS.
    I have not had MS ruled out due to multiple symptoms in the past. I am seeing my Fibromyalgia Doctor on Friday so hoping he can answer some questions.

    Last night I was in excruiating pain along my cheek bone, over to the connection with the Jaw (TMJ) and into the upper section of my teeth. The pain is still present today and it is like a stabbing pain.

    Can you give me anything you know about this condition and if so is it that common in those DX with Fibromyalgia?

    Thanks in advance
    Mark Pellegrino, MD responded:
    Hi Valarie,

    Facial and jaw pain is common in FM. Several structures including the head (scalp and brain), neck, TMJ, and facial/jaw muscles all have nerve branches to the face that can lead to pain, numbness, and altered sensations (called dysesthesias).

    If the pain comes and goes in relationship to another area of pain ie TMJ, jaw, neck, then it may be referred pain from myospasms or tm joint etc. If it comes spontaneously and feels like shocks or stabs, then it could be more neuralgia-mediated, like trigeminal neuralgia.

    Rarely in someone with FM, a different cause such as MS, Bell's palsy, acoustic neuroma, or even a viral infection (cold) can cause face and jaw pain. But these other conditions are usually evident by additional symptoms or a different clinical course that your doctor can determine by evaluating you.

    I try various treatments on my patients with facial pain including meds that block nerve pain (ie anti-seizure meds, SNRI's, tricyclics) and topicals with helpful meds (patches, compounded cream). Therapies including TNS trail, or injections, or bite splints or other treatments can be tried depending on the individual's cause of pain.

    As usual, I can't provide specific advice for anyone here but I encourage you to work together with your doctor for your symptoms.

    Dr. P
    ValarieW77 replied to Mark Pellegrino, MD's response:
    Thank you so much for your response !

    The advice is appreciated and thanks for your time

    It is sudden and shock like, stabbing pain that keeps coming and going. I thought after the other day it wouldn't return but BAM it hit me yesterday.

    I did talk with my Rheumy Friday at my Fibro appt and he also stated it is the nerve. He said we will keep a eye on it and hopefully I won't keep experiencing this (I was hopeful at the time until yesterday LOL )

    I am going to head to my primary on Monday to let her know of this new symptom also and go from there.

    THANK again !
    Candyland replied to Mark Pellegrino, MD's response:
    Hi Doctor,
    I've also been diagnosed w/ fibro. Separately, I was diagnosed with 3rd cranial nerve palsy. Starting in Jan, I had binocular diplopia and severe head & facial pain. It lasted 4 months, going away a little at a time. Now It's back, in Nov. Is this typical with fibro? Will it come and go? Is it progressive?
    Thanks for any advice you can give me.
    Caprice_WebMD_Staff replied to Candyland's response:
    Hi Candyland,

    I'm not sure when Dr. Pellegrino will have a chance to respond to you but wanted to welcome you here.

    I hope you'll start a new discussion to discuss this with our other members and/or just say hi.

    To do that hold your cursor over the orange Post Now button and choose 'Discussion' from the drop down menu which appears. Fill in the subject line and body of the message (you don't have to do the poll part) and Post.
    We must let go of the life we have planned, so as to accept the one that is waiting for us. ~Joseph Campbell

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