trigeminal neuralgia with head ache post cervical fusion

[Mimi0307]

I underwent a three level cervical disc fusion C45,C56, and C67, anterior approach on right.  I awoke from surgery with pain and headache on right side only with distribution along lower jaw, around and behind right eye, temple,  and going back behind right ear toward occiput.  It seems the trigeminal distribution, but rather than have the typical shooting type pain as a reaction to sensory input, it is pretty much a constant throbbing.  My surgery was three weeks ago and previously I had never had any of these symptoms.  I'm extremely active and refused to take pain meds with three herniated discs, but this demands medication for me to function.  Could compression or stretching of the trigeminal nerve during surgery cause  damage which is causing this neuralgia and head ache.  I have no infection and normal blood counts.  After trying two steriod dose packs and a Zpack suggested  by my neurosurgeon, I went to a general practioner to make sure I had no infection or other cause.  Except having  high blood pressure, which I usually have low blood pressure, everything was within normal limits.  I feel the BP is due to pain.  I'm a working physical therapist. I don't go back to my neurosurgeon for recheck for two more weeks.  I need to work and return to my active life.  Please advise if you think  this could be the correct diagnosis or suggest ideas.  Thank you so much!

[Yafffie]

A related discussion, Trigeminal neuralgia after trilevel cervical desectomy with fusion was started.

[Mimi0307]

Thank you for your response.  I did report to my neurosurgeon.  I had an MRI which showed no abnormalities.  I continue to have recurrent pain and headache in the trigeminal nerve distribution.  I am on Lyrica, which does help, but I continue to have increased hypersensitivity in right forehead, righteye, right side of nose and pain in eye, temple (very sensitive to palpation), TMJ, and back teeth (toothache pain in back lower right tooth).  I also have soreness in right side of throat.  I am just interested in if there have been cases where the Trigeminal Nerve was compromised by compression (maybe how my head was stabilized during cervical fusion) or the trama of surgery itself.  I'm trying to understand what happened as I awoke from surgery with these symptoms.  I'm also trying several treatment approaches to help.  I am exercising in the gym to decrease effects of feeling medicated and am trying to desensitive the areas of my face by providing tactile stimulation.  Are there any studies of treatment approaches besides taking medication that have been effective in decreasing symptoms or decreasing epidsodes of pain.  Presently I am still having episodes of more severe pain, but episodes seem less frequent.  Thanks!

[Michael Lim, MD]

In general TN symptoms consist of shooting/stabbing pain.  Sometimes patients can have headaches after cervical surgery.  I would see your surgeon and talk about your symptoms with him/her.