History

Age: 69

Gender: Male

Initially seen in December of 2004, the patient complains of right facial pain following shingles a few months ago.  He says that he has pain on the right greater than the left, which he says radiates from his ears into the jaw. He says the pain episodes occur one to two times per day.  He denies any problems with dental occlusion, clicking or popping of his jaw or bruxism.  The patient admits to hearing loss, AD greater that AS, and occasional hissing tinnitus.  Case notes do not state whether it is unilateral or bilateral or its severity. He denies any drainage, aural pressure, vertigo or imbalance.

Medications: Lipitor, Neurontin, Glucophage XL, Flomax, Aspirin, and Ambien

□   What is bruxism, and why would the ENT and/or audiologist be asking about this?

□   You can sometimes tell what medical conditions a patient has by looking at his or her medications.  This patient is not an epileptic; why is he taking Neurontin?  What other medical conditions do you think this patient has given his medication list?

Case Credit: This case was donated by Dr Bradford Ress, Ress Institute, Boca Raton and by Michele Bruszer, then at NSU.