Headache-Adviser.com

Recurring Pin Prick Shocks

by Anon

I am a 46 year old female. I have not smoked in 20 years. I have diabetes type II with good control. I take metformin for this. My blood pressure is controlled with diovan. I take potassium. I also take cymbalta for depression. I also have parotid myopathy. I have had cat scans on my parotid and general area every couple of years with no change.

I get terrible jaw pain on both sides of my face at the same time that lasts 10 to 20 minutes. I have had severe pain behind my right ear even as a child this pain happened very fast and was very severe and disappeared about as soon as I can react to it. I am sometimes wakened from a dead sleep with an intense but fleeting shocking or stinging pain in my mouth sometimes under my tongue or in the gums around the back teeth or on the sides of the tongue. A couple of weeks ago the pain lasted longer and covered a larger area of my tongue waking me up from a dead sleep.

I also have this shocking or sting senasation on other parts of my body like my back, arms, or feet. These seem to be totally random and for the most part by the time i react to pain it stops. This can happen at any time including my sleep. However, a month or two ago I woke up with the same pain 2-3 inches above my right elbow on the inside of my arm and the pain not only lasted but cover the area of about a quarter. I have no rash or marks on my body from these and they seem to be getting more frequent.

Answer:

Hi,

I would like to address the head pain first. You sound as if you are having a rare type of headache ( or head pain) known as glossopharyngeal neuralgia. This is a cranial nerve that innervates the tongue and when irritated, perhaps by pathology in the mouth such as parotid gland problems, can cause this type of neuralgia.

There is also another rare condition called Neck and Mouth syndrome, where pathology in the neck at the C2/C3 level can lead (though neurofeedback to the brainstem) to problems in the tongue. Usually with this though, the problems are only in the tongue with taste disturbances and tongue pain.

In your case the radiation to the jaw and behind the ear points more towards neuralgia. I would speak to your doctor and ask about being put on gabapentin or one of the other anti-seizure drugs used for this. You might also want to see a neurologist if you haven't already.

The other symptoms could be related to your diabetes. Unfortunately, even with good control, diabetes can progress. Nerve problems or neuropathy is common. Gabapentin is also the treatment here and again a neurologist should direct this. Vitamin B12 levels should be check as this deficiency can cause random tingling and pains in addition to tongue pains. Other causes of tingling include anxiety.

Good luck.
Mary Kay Betz MS RPA-C

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Neuralgia

by Steve

Hello,

I am a 54 years old male. I suffered from Neuralgias, stabbing sharp pain in my head, like around the top part of my left ear.
This happened suddenly. I will say happens 4 times a year.
They did MRI and Cat Scans and nobody found anything.
I do not smoke, use drugs, neither drink.
My colesterol is around 250. And 6 months ago I was border line pre-diabetic, now is normal.
I have sleep apnea, very severe, I used a breathing machine for sleeping.
I am probably like 20 pounds overweight, not bad.
I do not do exercise, my work is very sedentary and I feel tense because of a lot of work.

The only thing that a doctor prescribed to me is KETOROLAC (anti-seizure medicine), which before help me just taking one or two tablets. But this time is not helping at all.

Please advise, thank you!

Steve

Answer:

Hi Steve,

Ketorolac is not an anti-seizure medication, it is an anti-inflammatory. Usually anti-inflammatories are prescribed for tension type headaches which can be episodic and have stabbing pain at times. More often than not they are throbbing.

Next, I would wonder about the CPAP mask..perhaps is it too tight on occasion and causing this problem? If that has not been check in over a year, consider calling the company who supplies it and ask for a re-fit.

Finally, next time you see your doctor, ask them to examine your neck to see if you have spasming. Most people over the age of 50 have some arthritis in their necks and this can cause spasm. The spasming then pulls on scalp muscles causing headaches. Here is some more information about headaches and neck pain.

Good luck!
Mary Kay Betz MS RPA-C

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