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Old Yesterday, 04:49 PM
 
Location: The Driftless Area, WI
1,827 posts, read 679,756 times
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Quote:
Originally Posted by bluedevilz View Post
The OP already stated her problem was in fact scleritis and the symptoms described in the OP are classic for scleritis with pain radiating from jaw to head exactly as described the doc also made the diagnosis after an eye exam....it also typically responds to steroid treatment just as described by the OP

The symptoms sound NOTHING like Trigeminal Neuralgia which typically presents as SHORT bursts of intense pain, not pain that lasts a couple of weeks as noted...there would have also been nothing on an eye exam to suggest scleritis that was actually Trigeminal Neuralgia
Stop speed reading. I think I covered all your objections....Trigeminal neuralgia does not present as short bursts. It is generally described as excruciating pain akin to the pain when the dentist "hits a nerve" while drilling and lasting minutes to hours to continuous, usually waxing & waning over several hours in cycles. It probably has multiple causes, from infectious & inflammatory to mechanical or a seizure variant.


Scleritis hurts ON the eyeball, while the ocular branch of the 5th N innervates NEAR the eye. With scleritis, even the nave patient knows there's something wrong with his eye if he ever looks at it in the mirror. https://www.bing.com/images/search?q...ye&FORM=HDRSC2With TN, there's no physical signs, excepting the occasional palpable submandibular node.


edited to add: a dx of Herpes zoster should also be entertained (maybe more likely considering absence of mandibular pain & prominence of headache). It occasionally occurs without the classic rash. With the rash, the dx is obvious, of course....what bothered me was that the PCP didn't call it scleritis. That should have been obvious on first presentation if it was the right dx.

Last edited by guidoLaMoto; Yesterday at 05:06 PM..
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Old Yesterday, 11:53 PM
 
4,680 posts, read 10,587,051 times
Reputation: 10537
Quote:
Originally Posted by guidoLaMoto View Post
Stop speed reading. I think I covered all your objections....Trigeminal neuralgia does not present as short bursts. It is generally described as excruciating pain akin to the pain when the dentist "hits a nerve" while drilling and lasting minutes to hours to continuous, usually waxing & waning over several hours in cycles. It probably has multiple causes, from infectious & inflammatory to mechanical or a seizure variant.


Scleritis hurts ON the eyeball, while the ocular branch of the 5th N innervates NEAR the eye. With scleritis, even the nave patient knows there's something wrong with his eye if he ever looks at it in the mirror. https://www.bing.com/images/search?q...ye&FORM=HDRSC2With TN, there's no physical signs, excepting the occasional palpable submandibular node.


edited to add: a dx of Herpes zoster should also be entertained (maybe more likely considering absence of mandibular pain & prominence of headache). It occasionally occurs without the classic rash. With the rash, the dx is obvious, of course....what bothered me was that the PCP didn't call it scleritis. That should have been obvious on first presentation if it was the right dx.
I'M speed reading???

Maybe you should go back again and READ what the OP posted....

Here let me help you....

"Thanks for all the info. Had a follow up today and she said it's scleritis, which is apparently more common with people who already have arthritis. I was in a bad way when I first went to see her so must have heard it wrong"

So the PCP DID call it scleritis from the beginning which the rest of us seemed to catch but you didn't which makes all your subsequent conjectures on possible differential diagnoses kind of superfluous doesn't it?????
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