Dr. Hitesh Kumar
Neurology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have a burning sensation in my left nasal cavity only when inhaling for the past six months. Then my throat started feeling sore on the left side, and I noticed my tensor veli palatini muscle spasms every time I breathe. I was having pain near my tonsil. And my temperature was ranging from 99-100.5.
I went to three ENT doctors. The first two could not figure out what was wrong. The third suggested that he could remove the tonsil. So he did. After that, the pain subsided substantially. The tonsil was removed three weeks ago. But I noticed muscle spasm still when I breathe. And now my nasal cavity has that burning sensation again. And today, my throat seems sore and painful right around that muscle again. My doctor referred me to a neurologist, but it will be a while before getting me in. Could the muscle be the cause of all of this? Also, they found a mucosal retention cyst in my sinus on the same side. And all of my bloodwork was normal.
Hello,
Welcome to icliniq.com.
I would like to know some details of your symptom.
Was it a burning sensation or sore feeling or electric current sensation in the left nasal cavity? Was this feeling inside the nasal cavity only or also outside? Does that feeling occur only while inhaling or touching outside the nose by hand or handkerchief or putting a finger inside the nose? How did you conclude it to be spasm of tensor veli palatini muscle? What exactly you felt to make this conclusion?
Do you have any burning, tingling, or electric current like sensation in the throat, especially while swallowing or chewing? Do you still have a fever these days? If yes, how many degrees is it? If not, how many days fever lasted?
I would also like to get all your prescriptions, surgery discharge summary, CT, MRI, and other reports.
Regarding follow up
Patient's Query
Thank you doctor,
It was a burning sensation in the nasal cavity. The feeling is in the nasal cavity and possibly the maxillary sinus when touching from outside. But I do not have pain when inserting the finger in the nose. I saw a tissue pulling inward and upward between the tonsil and the throat. I have no sensation in my throat while swallowing or chewing. I do not have any fever since the surgery. But prior to that, it lasted at least a couple of months.
I have attached for CT scan images and a video.
Hello,
Welcome back to icliniq.com.
As per your description, there may be a possibility of some infection (which might get better by antibiotics and antihistamines) followed by some residual inflammation in the nasal cavity mucosa.
I am still unsure about the muscle you are describing. I would like to see the video if you can upload it.
Also, I would like to know if that burning sensation is persistent or occurs momentarily and recur in between?
You have sent only four pics of MRI images (attachment removed to protect patient identity). I suggest you to upload all images from CT and MRI.
Differential diagnosis
Regarding follow up
Patient's Query
Thank you doctor,
The burning sensation is only felt when breathing. I have attached the video of the muscle.
Hello,
Welcome back to iclniq.com.
There is no attached video here. Please reattach the video and CT and MRI reports.
Patient's Query
Thank you doctor,
I have attached the video file. Also, those two CT scan images are the only ones I have access to. I do not have the other CT scan and MRI files. But the doctors said there were no findings on them, anyway.
Hello,
Welcome back to icliniq.com.
So with the available information, the possibilities which come in my mind are:
1. Residual inflammation of nasal mucosa (rhinitis) with sinusitis.
2. Trigeminal neuralgia.
You can give a try with tablet Gabapentin 100 mg TDS. Along with antihistaminics and nasal drops, whatever prescribed by ENT specialist. Also, try taking steam twice or thrice daily.
Update and review after one week of medications, regarding any improvement in symptoms.
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Neurology
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