Craig R. DuBois, M.D.
The Pain Evaluation & Treatment Center
7307 Creekbluff Drive
Austin, TX 78750
512-346-6969
http://www.paineval.net/our_physicians.nxg
Transcript: Pain when eating or swallowing?
An unusual circumstance but it’s very disturbing when it happens is some people will have some pain so bad that they can’t eat. There’s another condition similar to trigeminal neuralgia called glossopharyngeal neuralgia. GPN would be that abbreviation. It’s affecting the ninth nerve back in the throat and you can have pain from simply breathing, swallowing, you know some people laugh, talking but in particular those people have tremendous trouble with trying to swallow something triggers off their pain. So, there’s a few tricks you can do. We have them swish and swallow or swish and spit. Some 4% Lidocaine, it’s a strong Novacaine/Lidocaine component. And it will kind of numb it up a little bit but candidly it doesn’t work real well. But it’s an option to try and get something. Usually with the people, you try and use the medication, preventative medications and bring it up. And you may even get somebody semi-toxic or too high a level to get some pain relief.
Now, I’ve had a patient with geniculate neuralgia, a facial nerve injury and pain. And he basically was wasting away. I mean he just dropped 40, 50, 60 pounds and we were afraid we were going to lose him from not eating. So that’s a case where we brought in the narcotics. Now was it helping his pain or just blunting everything? Probably blunting everything but we were going to lose him. And so you find some different techniques to just say “What do we have to do to keep this person alive while we try and find another mechanism to help the underlying pain state?” It’s a big problem for some people.
I also see people who have trigeminal and they’re in their V2 and in their lip and sometimes they can go to a more liquid nutrition, some of the Ensures and kind of do a side straw. It’s not a great way to do it but again, you are trying to keep them going while you’re getting other things underway.