4 Differential Diagnosis
The right diagnosis at the right time can make all the difference in a person’s ability to understand, treat, and cope with trigeminal neuralgia. To avoid the long, frustrating road of misdiagnosis, experts recommend these steps.
First, if you have tooth pain, see a dentist. Ask if he is familiar with trigeminal neuralgia. If he is, encourage a differential diagnosis before getting any teeth extracted. If he isn’t, leave.
Second, make an appointment with a neurologist as soon as possible. These are the folks who understand the condition and how to help you. It may take some time to see one in your area, but you can work on a temporary plan with your primary care physician in the meantime.
Third, if you have to go to the emergency room due to the severity of the pain, be prepared to have your pain questioned. ER docs aren’t TN specialists, so offer what you know about the condition. (Have it on a piece of paper because you’ll likely be in too much pain to talk.)
Also ask if they have a neurological consultant on hand. Remember, typical painkillers and opiates will only help the pain mildly. The first form of emergency intervention is a fosphenytoin IV (otherwise known as Dilantin). Ask the doctors about it. (Again, having the information on hand will really help you out when you’re in extreme pain.)