Chronic sinusitis but prescribed Carbamazepine for Trigeminal Neuralgia

[CheapHouse]

For the last 2 years I've been on antibiotics, allergy tablets and steroids to try to treat my ongoing sinus pain in my face and headaches.

I want my GP to refer me for a sinus x-ray, I'm sick of having daily headaches and going on all these different meds. I want to know the cause of it.

All of a sudden he prescribed me Carbamazepine which I've googled is for Trigeminal Neuralgia. I'm not sure why he has done that other than trial and error and to shut me up for a bit.

He told me that the backlogs due to lockdown means he can't refer me to get an x-ray. I'm so bad at asserting myself with medical professionals, I don't know what to do.

Any advice appreciated

It sounds like he wants to rule out Trigeminal Neuralgia. If the carbamazepine works, your pain is more likely to be TN than sinusitis (I’m a TN sufferer with over 20 years experience of this drug).

@Pushkinia thanks for your reply. I had never even heard of it before I googled. If you don't mind answering do you have any sinus issues? Like inflamed or painful sinuses?

I only have sharp pains occasionally. He's also prescribed me something for my sinuses to go along with it...an aerosol saline rinse. So he must know there's some sinus issue.

I had atypical Trigeminal Neuralgia misdiagnosed as chronic sinusitis for years. Well worth ruling it out, though odd your GP didn’t explain his thinking.

I believe mine was triggered by a reoccurring dental abscess above my top front tooth that several dentists missed. I’d have a thorough dental examination too.

@SoggyDoggyWalks he's just so rushed. Whenever I have an app I come out of it thinking I've not had enough time to explain my symptoms properly. He fires questions at me before I've finished answering the last one.

@SoggyDoggyWalks oh that's helpful!...I've just googled atypical Trigeminal Neuralgia and that seems to describe what I'm experiencing. That's reasuring as it makes more sense now.

The worst and most consistent symptom is the headaches.

@CheapHouse I thought I had sinusitis at first - it was the GP who suggested TN. I had heard of it but thought it only happened to old people (I was 31!)

My TN is complicated because the pain is mainly atypical - heavy waves of pain that feel like my face is trying to tear itself apart - but it comes and goes in flared like typical TN. I’ve also had the electric shock like pain of typical TN.

I had sinusitis recently and needed nasal spray and antibiotics but the pain was quite different from my TN pain.

Yes I'm in my 30's. It would explain the twitch I get in my left eye.

@Pushkinia how was your TN diagnosed?

I don't know if I should be pushing for a sinus x-ray or even an MRI scan to work things out

@CheapHouse I had terrible pain down one side of my face (on and off) for two years and had made many trips to the dentist, assuming teeth were to blame. The dentist didn’t know either, and recommended I had all my wisdom teeth removed.

The pain returned after the surgery and my mother suggested it might be neuralgia, so I saw a GP, who finally diagnosed it. He refused me carbamazepine, put me on gabapentin instead (which did nothing!) After another 8-9 months, I got a referral to neurology, who confirmed the diagnosis and told the GP to put me on carbamazepine. He also referred me for an MRI scan (waited 18 months for that!) but it didn’t show anything worrying.

This was 25 years ago!

Oh my, how awful to have your wisdom teeth out for it not to have made a difference. Sounds terrible!!

That's interesting that it took a referral to neurology to go on Carbamazepine and I seem to have been given it with no real diagnosis 🤔🤔

I’m not sure what my GP thinking was about, refusing the carbamazepine, but the gabapentin gave me so many bad side effects and no improvement in the pain at all (the GP didn’t believe me when I told him this!). I had to push for a neurology referral.

The wisdom teeth thing was a nuisance but all four were impacted, so probably better out than in. I was willing to try anything to ease the pain. I even tried acupuncture, although it didn’t work for me.

I have both typical and atypical TN, and also chronic sinusitis - I must say, they are very different pains from each other! I’d definitely see if you can get an MRI - mine showed an epidermoid cyst pressing on the nerve causing all the issues.

@GreenCereal ah so I could have both!! Have you had your syst treated?

So far the Carbamazepine is making me nauseous I have to eat little, often and bland! Hopefully that will calm down a bit.

Yesterday and today I have had no headache...which I almost forgot what that felt like. I'm trying not to get my hopes up because in two weeks I normally get one or two good days anyway.