FAQ - trigeminal neuralgia
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trigeminal neuralgia?

I have had severe facial pain and shooting pain through my left ear. Dr. has been treating me for trigeminal neuralgia. Yesterday I woke up and couldn't and still can't open my mouth more than an inch. The pain can be so bad I can't function. Does anyone know much about this and could it be related to an old filling in my tooth or other dental problem????

TN is not usually characterized by the inability to open your mouth, it's usually a sudden, severe, electric shock-like or stabbing pain typically felt on one side of the jaw or cheek. The attacks of pain, which generally last several seconds and may be repeated one after the other, may be triggered by talking, brushing teeth, touching the face, chewing or swallowing. Is your doctor sure that's what you have? It almost sounds more like TMJ. TMJ / TMD, or temporomandibular joint disorder, is a term used to describe a group of symptoms including headaches; facial pain; jaw pain; sore, chipped, broken, or worn teeth, clicking or popping in the jaw, and limited jaw movement. In many cases people suffering from TMJ / TMD report chronic pain in the jaw, teeth, face, head, neck, shoulders, or back, or any combination of these areas. Snoring, grinding of teeth, frequent ear infections and restricted airway are other problems associated with TMJ / TMD. This group of symptoms is also referred to as MPD (myofascial pain dysfunction) and craniomandibular dysfunction. See your doctor and/or dentist and get a definative diagnosis.  (+ info)

Trigeminal Neuralgia?

My sister is 50 years old with diagnosed right side trigeminal neuralgia,pain most of the time.She tells her story as follow,

I am 50 years old healthy south asian lady .A year ago I have amenorrhea.
My sleep is disturbed.I get this pain any time of longer duration.It is like
pinching needles and sometime dull.I have no family history.I am not sensitive
to light.My pain does not go away with heat or cold application.my colour is white.I have one daughter.
I have been diagnosed with Trigeminal Neuralgia on right side of my head with severe
pain.The pain started right after my Dentist did deep clean of my teeth inside on right.
Have been using medicines like Ibuprofen,asprin,acetaminophen but it is temporary tretment.
I heard that there is a good permanant long term treatment for Trigeminal Neuralgia in Homeopathy.
I never used any homeopathic medicine before.I donot have any disease in childhood.never have headache
before.my sleep is disturbed.i get this pain any time of longer duration.It is like pinching needles and sometime dull.
.I am not sensitive to light. pain does not go away with heat or cold application.My colour
is white. all reports on Head, MRI,CT scan,X rays,Hormone assay ,blood testing are normal. .She have NO Hypertension,
Diabetes,cancer and allergies .
Have never used any homeopathic medicine before.Please give me the name of best homeopathic medicine with dosage and precautions.

If your sister had neuropathy of the trigeminal nerve, I feel so much compassion for her. It is reportedly the most severe pain that a human can experience, greater than child birth and gun shot wounds. I can personally attest to the great pain, as I also suffered from neuropathy of the trigeminal nerve.

Trigeminal Neuralgia is a medical term of art, which means that the blood vessels in one's head by the trigeminal nerve have become elastic and wrapped around the nerve causing excruciating pain with compression. If you don't have the blood vessel problem, then it is called Atypical Facial Pain or Trigeminal neuropathy, which is caused by other means. I had AFP.

Trigeminal Neuralgia is often cured by surgery. The blood vessels are unwound and maybe afixed so the problem does not come back. You must see a neurosurgen for advice.

AFP may have different causes. In my case, the facial muscles were very tight (I had a muscle disorder due to being poisoned from airborne toxins, which caused my facial muscles to spasm). My muscles would spasm for weeks/months never letting up, and in fact shifted my face and changed my teeth alignment, and the roof of my mouth. These muscles squeezed on the trigem. nerve continuously causing excruciating pain, like being sliced open with a razor blade in the cheek bone and leaving it exposed to the air. Also my teeth hurt, but had nothing wrong with them, just the nerve reacting at its tips by the teeth.

It took FOREVER to figure this out. I wanted to cut off half my face.

It seems like maybe your sister is also having a reaction with tight muscles after her dentist did some work, since it was a cleaning and not surgery?

Here is what helped me: acupuncture, neuromuscular facial massage to break down the muscles and get them to relax, and pain medicine and muscle relaxers. Because I had been poisoned, I was very intolerant of many chemicals and pharmaceuticals. I can take oxycodone for the pain and ativan sublingually as a facial muscle relaxer. The emergency room doctors gave me the ativan sublingually as a muscle relaxer when I had gone there with an accute attack.

When muscles are squeezing on nerves causing pain, I have found that reputable pain clinics at hospitals are good, and physical therapists understand this problem better than surgeons or mds. Dentists wanted to rip out about 9 teeth, so make sure that any dental work like that is for sure required or that nothing else helps first. I refused the surgeries and dental work that was suggested and thank god, because it was totally unnecessary in my case. I had to get the facial muscles to quit compressing the trigeminal nerve.

I would not use homeopathic meds in this case. There is a physical cause here that can be quickly addressed for immediate relief and long term cure.  (+ info)

Trigeminal neuralgia?

Anyone have this? Can you please share your specific symptoms and the cause if it has been found. Have any of you had this linked to a brain tumour and what other symptoms have you had in connection with that.


Mango, in my medical practice I see on average 2-3 patients per year who have either been diagnosed with (or I diagnose with) trigeminal neuralgia (Tic Douloureux. The cause for this extremely painful-often debilitatingly painful condition is not fully understood, and episodes of attacks can range in frequency from 6-10/year to less than one attack every two years. In either event when an attack does occur the pain is overwhelming, and, as you probably already know, the slightest even most innocuous thing can trigger a severe attack.

There are a number of conservative treatments that work well for many patients. For more persistent cases there are other treatments, and in the most severe cases surgical intervention is often recommended.

On my personal website located at http://www.geocities.com/yale_er_doc I have devoted a page to neurological issues and on that page a section specifically for trigeminal neuralgia. The address above is also listed in my profile and will take you to the home page, you will find a pull down menu 3/4 of the way down the page and select the Neurology Center to reach the section to which I referred.

I hupe this helps somewhat.  (+ info)

What is the best surgery for trigeminal neuralgia?

My mom is 73 year old and diagnosed with trigeminal neuralgia. She's done with al kinds of pain medication and is now considering surgery. Any suggestion?

It depends on what is pressing on the nerve or where on the nerve the problem is. SHe needs to see a Neuro Surgeon.  (+ info)

Trigeminal neuralgia: can it involve a constant pain instead of a fleeting pain?

Classic trigeminal neuralgia involves a fleeting pain that is often triggered by an external stimulus. The cause is often found to be a blood vessel pressing on a nerve. Can that same situation (a blood vessel pressing on a nerve) cause a constant pain that is not triggered by an external stimulus? If so, is the blood vessel always apparent on an MRI? Or might an MRI miss it? Thanks for all replies.

Yes, TN can cause constant pain. When it does, it's usually classified as "atypical trigeminal neuralgia."

If a blood vessel is pressing on the nerve, an MRI ordered to focus in tightly on the trigeminal nerve ought to catch it, but sometimes the cause of trigeminal neuralgia isn't as readily apparent as a blood vessel pressing on a nerve. Sometimes (as in my case) there's no visible cause at all to explain why the nerve keeps firing.

There's a useful breakdown of the various types of TN and related facial pain problems here:

(Although bear in mind while reading it that this website is focused on MVD, so it tends to overstate both the probability of a blood vessel pushing on a nerve as the evident cause *and* the efficacy of the MVD operation as a cure for TN. Nonetheless, if you can overlook that, it's still a pretty decent breakdown.)  (+ info)

Can a toothache cause Trigeminal Neuralgia?

I know Trigeminal Neuralgia can cause a "toothache", but can a toothache cause a trigeminal neuralgia flare up in someone predisposed to them?

Please cite sources.

Yes it is possible especially those teeth supplied by the trigeminal nerve  (+ info)

Does anyone have Neuralgia or Trigeminal Neuralgia and what pain relief and medication are you taking?

Hi, I have Trigeminal Neuralgia and am not fining my pain relief effective or my medication but particularly pain relief i am taking up to 450mg of Codeine a day and Tramadol (not at the same time). It is not even touching the pain! Any advise from others who have this or from professionals who have come across this sort of problem? Any advise at all would be welcome even if it seems really obvious! Thanks, C x

Hi. I'm on Tegretol right now for my TN, and I also have oxycodone for breakthrough pain. The Tegretol isn't working for me at the moment, so I find I'm taking far more oxycodone that I'd like. I'm not in a very good place right now, pain-wise. I have an appointment with my neurologist coming up, but I'm sort of dreading it. I suspect he's going to want to titrate my dosage of Tegretol upwards, and I'm already having a really hard time with the side-effects. I think that it may be time for us to try a different anti-convulsant, but if we do that, then I'm going to need a lot more pain-killers to help me through the transition period, and even with that help, it's still going to be pretty awful.

Are you on an anti-convulsant, like Tegretol, neurontin, or Lyrica? They've only been partially successful for me, but I know they've helped a lot of TN sufferers to live very nearly pain-free. If the one you're on isn't working for you, it may be time to try another and see if it does a better job. There are quite a few of them to choose from, and everybody seems to react differently to them, so it's definitely worth checking to see if another drug might be more effective for you.

Pain-killers usually don't work on neuralgia nearly as well as they do on, for example, post-operative pain or muscle pain. For me, they don't stop the pain altogether; they just knock it down a few notches on the pain chart. But those few notches can make such a huge difference! I'm sorry that they're not even doing that much for you.

Have you been to see a pain management specialist, or gone to a pain management clinic? If not, I very much recommend it. They're experienced in dealing with these problems, and might be able to find a pain management regime that works better for you.

ETA: A good place to talk to lots of other people who suffer from this monstrous problem are the TNA Forums here:

You have to sign up first, but it doesn't cost anything and they won't spam you. The people there are friendly, and even just lurking there can make you feel a lot less alone. It did for me, anyway.  (+ info)

What caused my trigeminal neuralgia?

I have trigeminal neuralgia, an agonising condition involving pressure on a nerve in my face. I am on epilepsy drugs but am tired and forgetful and still in pain. I really feel my life, which until last year was perfectly happy, isn't worth living. I have no idea why I suddenly got this. I am only 25. It first occured at quite a stressful time. I have also had root canal treatment on the same side of my face. Of course the dentist denies all involvement, but I can't help thinking this could have triggered it. Any ideas? Or remedies?

My mother has suffered from this on and off over the past few years, and I wouldn't wish it on my worst enemy. So I feel really sorry for you. She has had some really effective tablets. I'll find out what they are, but when she was referred to see a consultant, he gave her an injection which gave immediate relief and seemed to have quite a lasting effect. She was also told that if the pain got unbearable again, she could phone up and have another injection. It's worth asking about this, and seeing if you could have the same back up for any future attacks. Good luck.  (+ info)

What causes trigeminal neuralgia? What are the things that triggers the pain? Any suggestion on what to avoid?

My mom suffers from trigeminal neuralgia I just want to know things on how to help her to ease the pain.. Thank You so much..Your info will be much appreciated..

I have suffered this awful condition, i was put on Tegretol (an epilepsy drug) and it went away. Im not sure what triggers it but....its tgh compression of the root of the trigeminal nerve by an abnormally positioned blood vessel is the most common cause of trigeminal neuralgia.
The pressure on the nerve causes it to misfire, resulting in pain. Occasionally, the compression is caused by a tumour, and sometimes there is no obvious cause found. Other, rarer causes of trigeminal neuralgia include multiple sclerosis and strokes affecting the lower part of the brain.  (+ info)

For those with trigeminal neuralgia or who know a lot about it?

My mother experiences a lot of pain in both sides of her face. While most times you can't see any facial redness sometimes her face gets very red and almost looks burnt. She hads the pain all the time, don't in shocks...such as those described in trigeminal neuralgia. She is currently going to the neurologist and has tons of test run. The doctor is pretty much doing a trial and error as far as meds go. They are treating her fortrigeminal nueralgia, but from what I read it doesn't seem quite the same as what she is experiencing. Do people with TN every have constant pain on both sides? I can not find any other conditions that even come close to describing what she has besides TN.

Thanks to anyone with advice.

i think it is normal to have pain on both sides but if she is being treated and it is not working maybe she could try other doctor  (+ info)

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