A life without the headache of the man has led the last 35 years ago. Since then, the complaints accompany him and Rob him of his quality of life, without he knows, where they come from.
Initially, the attacks came only a and, then, they were more frequent and more painful, until they had three to five seizures per week hardly breaks. To this point in time the 64-year-old man Council in neurological practice, of the San Fernando Teaching hospital, Trinidad and Tobago.
He reported to the Doctors as the pain sweeps over him, typically in the morning or in the evening: It begins behind the ear and moves in the direction of forehead and temples, always the right side hurts a little more than the left. Without drugs the discomfort to stay one to three days, but also with tablets, there is little relief.
Just a daily combination of Acetaminophen, Aspirin, and caffeine could help him for a long time. Then the man swallowed a combination of codeine, an opioid, and Paracetamol, but the headaches remained, reports the physicians to Antonio Jose Reyes in the “British Medical Journal”.
Diagnosis: Chronic Migraine
As the man reported to the neurologists of his complaints, he is free from fever, and appears at first glance to be healthy. He is not suffering from a disease of the nerves, he smokes, does not drink, take any illegal drugs. Although he has developed several years ago, high blood pressure, these, he holds, but with drugs in check.
On the basis of his descriptions, the Doctors diagnose a chronic migraine without Aura, he meets all the criteria, suffers from, for example, more than three months, the attacks and complains of throbbing pain that are exacerbated when he runs around.
The diagnosis is not new, from the beginning the Doctors were of a migraine. At that time, she prescribed triptans, typical migraine medicines. You triggered him, however, extreme dizziness, the man had to drop her off again. The cause for the migraines, but all the years, a mystery remained.
The neurologist start, the man a complete check through. They send his blood to the lab, to analyze, among other things, the sugar value is, looking for signs of a rheumatic disease, make x-rays of the chest, a CT Scan of the brain and look at MRI images, the blood vessels in his head. The result is always the same: everything is in the normal range.
Root canal treatments, fillings, pulled teeth
One thing afflicts the patients for years, in addition to his headache, as he reported: He has very bad teeth. Only Recently, the 64-Year-old root had to have treatments in multiple teeth endure, in others, filled the doctor holes.
In the case of Ask the man remembers that the headaches were in the past, often with the Tooth pain associated. The mouth prepared for increased problems, also hurt the head more often and harder. Once the headache disappeared, and even for some time, as he had completed dental treatment.
The 64-Year-old came in with the idea that his head could pain have something to do with his teeth. Also, none of his Physicians had previously suspected such a connection. For the neurologist, but he seems to be obvious, even if the remaining teeth appear at first glance to be healthy, not to Knock react and also discovered on the gums is nothing.
The neurologist will ask the oral surgeons, the 64-Year-old for advice, he should look for in the patient’s mouth for hidden Disease in the herd, he is actually successful. On x-ray images, two collections of Pus in the gums of the man, both on the right side, one above and one below a jaw of the tooth to show.
Trigeminal nerve: connection to the teeth
The oral surgeon removed the inflamed tissue. In addition, the Doctors prescribe to the man for ten days with antibiotics to fight the pathogens that triggered the inflammation in the gums. For the 64-Year-olds, it is the beginning of a new life. Fewer and fewer of the headache attacked him, eventually, they disappear entirely. After 35 years had improved his quality of life, tells the man in a follow-up examination 24 months later.
Headache and dental pain can be mediated by the same nerve, the trigeminal nerve. It is a well-known phenomenon that a migraine mimic in this way, tooth pain, write the physicians. Rare but is that a tooth pain, as the headache felt.
Nevertheless, the medical Doctors on call in case of unexplained headaches that radiate to the face, the oral health scale. One of the foci of Disease does not necessarily make apparent, write the Doctors. Especially in people with an intact immune system could be inflammation such as in the case of the man in the Depths of the gums, which prepare directly problems.