A 50-year-old lady has numerous swellings on her head and neck with severe tooth pain. Why?

Hi,

Welcome to icliniq.com.

Thank for the query.

I can understand your concern.

According to your statement, your patient has been suffering from swelling on the head and neck with a toothache. And your query is about the probable causes of her present clinical features with remedies. She is diagnosed with hypothyroidism, hypertension, ischaemic heart disease, heart failure, and osteoporosis with vertigo. Multiple swelling on the head and neck swelling may result from swollen lymph node due to infection or inflammation. Usually, head and neck swelling can arise from skin infection or other structures that can develop fluid retention, inflammation, or swelling nodes of the head and neck. These swelling types can occur due to viral infection, common cold, flu, salivary gland infection, or allergic reactions.

Hi,

Welcome back to icliniq.com.

The swollen lymph nodes in the head and neck can also be caused by an ear infection, infected tooth, sinus infection, strep throat, lymphoma, leukemia, mumps, tuberculosis, systemic lupus erythematosus, rheumatoid arthritis, allergies due to currently using medications, etc.

We should scrutinize her head and neck for detecting swollen lymph nodes. If lymph nodes are present, then FNAC (fine needle aspiration cytology) or biopsy should be done from the swollen lymph nodes. It can reveal the underlying cause for her present sufferings and then treat them accordingly.

She should undergo some investigations such as CBC (complete blood count), thyroid function test, an x-ray of the neck, CT (computed tomography) scan or MRI (magnetic resonance imaging) of the neck to exclude the other causes. Please monitor her blood pressure regularly.

Her current medication for osteoporosis is known as Risedronate sodium (35 mg). It is a bisphosphonate in a therapeutic class, has some severe side effects such as pain or swelling of the jaw, painful or swollen gums, severe toothache, loosening of teeth; swelling of the face, neck, head, throat, tongue, lips, eyes, hands, feet, ankle, lower legs, etc. So her present clinical features can result from taking Risedronate. You can stop this medication and observe her. If her symptoms are disappeared after stopping this medication over time, then it will be evident that Risperidone is the main culprit for her present sufferings.