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Q. My MRI report is normal, but I still have a shifting headache and facial pain. Why so?

Answered by
Dr. Abhaya Kant Tewari
and medically reviewed by Dr. Chithranjali Ravichandran
This is a premium question & answer published on May 15, 2022

Hello doctor,

I underwent an MRI two weeks back for my headache, which showed that my brain and cranial nerves are healthy. But my doctor suspects some abnormality in the superficial branch facial nerves and nerves passing from the skull base to the back of the head, as per the symptoms I mentioned. It has been nine weeks, and I am healing now. Somedays, the headache used to be throughout my head, whereas it is just the forehead or the back of the head on the other days. But now, the headache is a consistent dull pain up the back of the head, forehead, eyelid, and side of the face. Also, I have a tingling sensation above my eyelid and forehead. In the back of the head, it feels like a numbing pain. I apply Gabapentin ointment on my skin when I get a headache. Is this normal and standard for healing? How long does this usually take to heal?

I am concerned. Please help.

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Hello,

Welcome to iCliniq.com.

1) Looking at your symptoms, it seems you have facial pain, a headache involving the back of the head, numbness, and a tingling sensation. It is very difficult to spot one particular nerve for this kind of pain as these areas are supplied by several nerves. That is why your doctor has mentioned the cause as the whole superficial branch of nerves.

2) When more than two nerves are involved, the cause could be diffuse. The two most common conditions are migraine and tension-type headaches. Your symptoms are certainly not similar to the ones in migraine. Therefore, I suspect it to be an acute tension-type headache.

3) Local Gabapentin cream may help with these types of headaches. Also, I suggest you follow a routine with adequate sleep, relaxation exercises, and mild physical activity. If it does not subside, other medications are also available.

To reassure you again, the MRI (magnetic resonance imaging) would have ruled out if there were any underlying causes.

I hope this helps.

Hi doctor,

Thank you for the reply.

I have been facing these symptoms following my COVID-19 vaccination. Previously, I have had similar other issues and chronic migraines continuously for two months, which have subsided. So, I am left with nerve pain along the branch of nerves supplying the forehead, under the right eye, and the right side of the face.

Also, how long do these thread nerves take to heal?

#

Hello,

Welcome back to iCliniq.com.

The vaccine may have precipitated the issue. Generally, this kind of headache subsides within 8 to 12 weeks. However, now that there is a doubt between migraine and tension-type headache, and as both can overlap at times as well, it becomes very difficult to rule out the cause. So, if it is acute, it is likely to settle in 12 weeks or so. Do follow the instructions that I have mentioned, and it will settle down. Also, make sure to stay away from stress.

I hope this helps.

Please revert in case of further queries.


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