Ask a doctor on the topic of Neurology

facial pain

March 25, 2012 | 20,00 EUR | answered by Christian Welsch

Hello,
I have been experiencing pain in the right side of my face and ear area for about 10 days. It started with a feeling of toothache near the right tip of my nose (upper jaw canine tooth), but the dentist couldn't find anything wrong after taking x-rays and examining all my teeth. Over the days, the pain moved towards my ear in the upper jaw and remained persistent but bearable. I then went to see my regular doctor, who was unavailable, so I saw someone else in the same practice who examined me and even performed an EKG due to my high blood pressure, but everything was fine. I was referred to an ENT specialist with a suspicion of salivary gland inflammation or trigeminal nerve irritation, and after further examinations, only a slight sinus infection was detected on the X-ray, but I have had that before and it was never this painful. On Friday, I came home from work and suddenly experienced a sharp pain in my ear-jaw area, making me feel like my upper molars were about to fall out. Since I was planning to go on vacation the next day, we went to the emergency room, but the pain had subsided by then, leaving only a slight numbness. The doctor examined me again, but I had no further pain. I was advised to take ibuprofen 600 three times a day. Yesterday, there was no pain, but this afternoon I had another episode of intense pain lasting about 20-30 minutes. Tomorrow, I am scheduled to see my regular doctor again, who will hopefully refer me for an MRI. From what I have read, it seems to be related to this nerve, but the difference is that the symptoms usually last only a few seconds, not 20-30 minutes like in my case. I am concerned because I also read about brain tumors, but I would like to mention that I have been using a CPAP mask for the past 3 weeks, which puts pressure on the same upper canine tooth where everything started, and the head strap goes right under the ear where the nerve pathway from the head exits. Could this be related, and should I be seriously concerned, or is it possible to manage this nerve irritation?

Christian Welsch

Dear questioner,

you should wait for the results of the MRI, as this would also show whether a relevant sinusitis plays a role. I would also suggest trying a decongestant nasal spray and inhaling to relieve your pain. If it is related to the sinuses, improving pressure equalization can help. Sinuses are often irritated during ventilation therapy. If a conventional X-ray has been taken, it is not informative enough. You need a CT scan of the paranasal sinuses or an MRI. Tumors are usually not found during the investigation, most often nerve irritation is present.

Get well soon,
C. Welsch