Living With Facial Pain

Localized spot of pain on top of head aggravated by any mental effort


I believe I have some form of atypical trigeminal neuralgia, but only of the V1 opthalmic division.

There is one small, circular spot of pain on the top right side of my head that is dormant when I first wake up, but as I start doing anything, it comes to life and starts hurting.

It seems to “flare” up and get aggravated by mental effort, and especially anything particularly stressful or concentration intensive.

I would describe the pain as a boring, sometimes crushing type pain.

Most of the right side of my head/face feels different than the left side. In general I would say that at baseline it just feels more sensitive than the left. I am just more aware of the presence of the right side of my face.

I was wondering if anyone could tell by my description if they believe it to be atypical TN, or perhaps something else.

I do have migraine-type problems as well, not sure if they are related to the suspected nerve pain or not. Thank you.


You do have many of the hallmarks of an atypical TN type pain including:
–dormant at night and then kicks up after waking up and moving around.
–pain that is difficult to describe, but boring or crushing seems familiar
–pain kicks up worse under stress
–one side feels “different”

But I am not a doctor, so you probably should see a neurologist to get an idea of what this is, and if it could be something else going on. Migraines do seem to be often associated with this type of pain. Do you have any ideas of what gives you a migraine? If you keep track, you may find that certain foods or activities can bring on a migraine, then you can avoid them.


Ok. I totally have this same thing! Along with a whole host of other problems. You said that it doesn’t hurt in the morning but then builds through the day. My TN is always like that and it is a common pattern. Also, many Tners also suffer from migraines.
I have TN2 or ATN in all 3 branches but that one spot is a very common flare up for me. You said that the one side of your face seems to feel different then the other. Can you say which parts tend to “hurt” more. And you suffer from Migraines? Do you get it sort of behind the eye on one side?

The thing with ATN is that many of our symptoms sort of overlap several nerves areas or share very simular symptoms to other neurological problems. It is never cut and dry and each of us is very different. Every DR will say something different. It is so important to find a specialist. Groups help a lot too. Honestly, I have learnt more through talking with other TNers then anything else.

Have you tried any meds yet? or have anything that helps?