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2/4 Trigeminal Neuralgia , TN, aka tic douloreaux,

Click Slide Show Draft for New TN Patients.  Bookmark this page now!
 

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Welcome,

Trigeminal Neuralgia , TN, tic douloreaux, is the trigeminal nerve producing  false signals from the brain sending excruciating lightening strikes of facial pain to one side of the face.  Treatment is by medication, radiosurgery, craniofacial surgery or neurosurgery  or Microvascular Decompression  (MVD) for nerve pain relief. Trigeminal Neuralgia typically is near the nose lips, eyes, or ears.

This  compendium is also "Brian's Pain Journal". Let me hear about your face pain. I can publish on the web  anything you have to say about  trigeminal neuralgia. It will help other with face pain.  We can become "Pain Pals". The cause and permanent cure for
tic douloreaux (TN) are still unknown.  If your group would like a speaker about TN  call me. 

This letter is for the record and to keep a PAIN JOURNAL of where the above stated title problem stands. 

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Page 5 of 7 Tim Guith Sections 101 to 125 Opiods

http://www.BrianNelsonConsulting.com/trigeminal-neuralgia-tn/tim-guith.html  UD 09/06/2006 12:11:19 PM -0500

 Page 6 of 7 Bilateral Facial Pain and Bitter Taste in the Mouth. http://www.briannelsonconsulting.com/trigeminal-neuralgia-tn/bilateral-facial-pain.html 

Page 7 of 7 Patient Painful Stories  You are at: http://www.BrianNelsonConsulting.com/trigeminal-neuralgia-tn/patient-painful-stories.html

You can find this site again  by typing  the word "neuralgia1" backwards, ie.  OR "1aiglaruen"in Google. Brian "

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If after you scan to the bottom of this  website and still can't find the information you are looking for try another Google search here.
Contact information for this Website:
 
Brian Nelson, Webpage Marketing Consultant 

 31 Gessner Rd. Houston, TX  09/06/2006 12:11 PM -0500
713-467-3025  Fax 713-467-3192  
Click: E-mail me
Trigeminal Neuralgia, aka Tic douloreaux  or  TN
&
Temporomandibular  Joint aka TMJ  Eventually Cancer.This website is about Brian Nelson's fight with a parotid (salivary) gland tumor. It started out with the symptoms of  Trigeminal Neuralgia, aka Tic douloreaux  or  TN & Temporomadibular Joint aka TMJ Click Here to see my other record file at IAmFightingCancer.com  Bookmark this page now!  
 
Scan down to read my very lengthy and detailed web journal. Call me if I can help you. 713-467-3025 Brian
Signature Card For:                 Brian Nelson    31 Gessner Rd. , Houston, TX  77024
Tel. 713-467-3025 (Refers to my cell)      Fax 713-467-3192        
Click here to e-mail me.

www.NelsonIdeas.com
       Make a difference in the world!  "Idea Possibility Consulting"
www.BrianNelsonConsulting.com    There are so many new ways to make more profit. 
www.PartyTentCity.com 
                                The best modular party tent you can buy!
www.IamFightingCancer.com   Brian's story on Cancer and TN.  Post your Cancer story!

Bookmark this page now!

Misspelled Words on this pagetrigemnal, trigeminal, trigemial, trigeminl, tigeminal, trgeminal, trieminal, trigminal, trigeinal, trigeminar, tligeminal, tligeminar, tr1gen1ma1, tr1gen1mal, trigenimal, trigemimal, trigeminla, trigemianl, trigemnial, trigeimnal, trigmeinal, triegminal, trgieminal, tirgeminal, rtigeminal, trigemina, rigeminal, neuralgia, nuralgia, neralgia, neualgia, neurlgia, neuragia, neuralia, neuralga, neurargia, neurargai, neulalgia, neulalgai, neulargia, neulargai, neuralgai, neura1g1a, neuralg1a, meuralgia, neuraliga, neuraglia, neurlagia, neuarlgia, nerualgia, nueralgia, enuralgia, neuralgi, euralgia, tic, tik, tick, t1c, tci, itc,dou1oreaux, douloreaxu, douloreuax, douloraeux, douloeraux, doulroeaux, douolreaux, doluoreaux, duoloreaux, oduloreaux, douloreau, douloreax, douloreux, douloraux, douloeaux, doulreaux, douoreaux, doloreaux, duloreaux, ouloreaux, douloreaux,tenporomad1bu1ar, tenporomad1bular, tenporomadibular, temporomadibulra, temporomadibualr, temporomadibluar, temporomadiublar, temporomadbiular, temporomaidbular, temporomdaibular, temporoamdibular, tempormoadibular, tempoormadibular, temproomadibular, temopromadibular, tepmoromadibular, tmeporomadibular, etmporomadibular, temporomadibula, temporomadibulr, temporomadibuar, temporomadiblar, temporomadiular, temporomadbular, temporomaibular, temporomdibular, temporoadibular, tempormadibular, tempoomadibular, tempromadibular, temoromadibular, teporomadibular, tmporomadibular, emporomadibular, temporomadibular

Trigeminal Neuralgia, aka Tic douloreaux  or  TN
& Temporomadibular Joint
aka
TMJ  Eventually Cancer.

Trigeminal Neuralgia , TN, tic douloreaux, is the trigeminal nerve producing  false signals from the brain sending excruciating lightening strikes of facial pain to one side of the face. Compendium

Trigeminal Neuralgia , TN, tic douloreaux, is the trigeminal nerve producing  false signals from the brain sending excruciating lightening strikes of facial pain to one side of the face.  Treatment is by medication, radiosurgery, craniofacial surgery or neurosurgery  or Microvascular Decompression  (MVD) for nerve pain relief. Trigeminal Neuralgia typically is near the nose lips, eyes, or ears.

This  compendium is also "Brian's Pain Journal". Let me hear about your face pain. I can publish on the web  anything you have to say about  trigeminal neuralgia. It will help other with face pain.  We can become "Pain Pals". The cause and permanent cure for
tic douloreaux (TN) are still unknown.  If your group would like a speaker about TN  call me. 

Page 4 of 6.

 
by  Brian Nelson
bnelson@PartyTentCity.com

713-467-3025 Houston,  TX 

  Hi Aiglaruen

1 Brian Nelson
www.BrianNelsonConsulting.com
http://www.Internet-Marketing-Sales-Strategies.com
www.PartyTentCity.com
31 Gessner Rd.
Houston,  TX  77024
713-467-3025,  Fax  713-467-3192
 bnelson@PartyTentCity.com

Research on Brian's Pain Management.

What Is Trigeminal Neuralgia?

Brian Nelson’s Report Pain on Left side of Head.
Document Initiated on 8-22-04  Last update 8-30-04 620am ..

Brian Nelson, 31 Gessner Rd. , Houston, TX  77024
bnelson@PartyTentCity.com  , 713-467-3025 .

This letter is for the record and to keep a PAIN JOURNAL of where the above stated title problem stands. 

 Page 1 of 4 Section 1-25
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You  are at Page 4 of 4 Section 76-100
http://www.BrianNelsonConsulting.com/trigeminal-neuralgia-tn/faq-info4.html   ud 09/06/2006 12:11 PM -0500

Here is an interesting MVD website about surgery successes. I am surprised it was on the net.   http://www.hfs-assn.org/surgery.htm 

 MTNSB   Include page Pending Paste.


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76 From: http://facial-neuralgia.org/conditions/tn-gn.html

GLOSSOPHARYNGEAL NEURALGIA
Conditions: Other Cranial Disorders

Disclaimer.

Glossopharyngeal Neuralgia is described as a deep stabbing pain in one side of the throat. The pain is near the tonsil area and can extend into the ear. Thomas J. Lovely, M.D. , Peter J. Jannetta, M.D. of the University of Pittsburgh have a brief discussion on their experiences treating this condition at: Glossopharyngeal Neuralgia.

Links:

Glossopharyngeal Neuralgia - Singapore Journal 1999

Medline on Glossopharyngeal Neuralgia

Merk Manual-- glossopharyngeal neuralgia

Glossopharyngeal neuralgia, CCND Winnipeg

Glossopharyngeal neuralgia University of Pittsburgh

Glossopharyngeal Neuralgia , B.Todd Troost

The following article goes into greater detail although it does not discuss microvascular decompression surgery as a possible treatment..

The following article is excerpted from:
 
THE MANAGEMENT OF PAIN,
VOL 1, Second Edition, 1990, Lea & Febiger, Philadelphia]
CRANIAL NEURALGIAS
John D. Loeser

This article is posted here in compliance with the FAIR USE DOCTRINE and is for educational purposes only, not for commercial use.

"Glossopharyngeal neuralgia is characterized by shock like pains in the territory of the glossopharyngeal nerve. It is in every way similar to tic douloureux except for the distribution of the pain and the customary site of the triggering stimulus.

Etiology

"The vast majority of patients with glossopharyngeal neuralgia are thought to have an artery compressing the nerve as it exits from the medulla and travels through the subarachnoid space to the jugular foramen. This syndrome can be seen in patients with multiple sclerosis, but it is rare.

Symptoms and Signs

"Glossopharyngeal neuralgia is characterized by excruciating shock-like-pain in the region of the tonsilar fossa, pharynx, or base of the tongue. It can radiate to the ear or the angle of the jaw or into the upper lateral neck. The trigger zone is often in the same area, and patients frequently report that swallowing, yawning, clearing the throat, or talking is the precipitating stimulus. The pain often appears to be spontaneous. Chewing or touching the face does not precipitate an attack. Glossopharyngeal neuralgia is much less common than tic douloureux---the incidence ratio is about 1:100.

Diagnosis

"The nature of the pain, its description by the patient, and the chronology of the attacks are identical to those of tic douloureux of the trigeminal nerve. Indeed, glossopharyngeal tic is sometimes mistaken for mandibular division trigeminal tic douloureux. Involvement of the glossopharyngeal nerve can be demonstrated by localizing the triggering stimulus to the pharyngeal structures that it innervates. Blocking the trigger area with local anesthetic can confirm the site of the trigger and nerve involvement. This is unsuccessful in some patients because the vagus nerve can contain the involved sensory fibers. The role of the glossopharyngeal nerve in the regulation of heart rate and blood pressure is thought to be why some patients with glossopharyngeal neuralgia have profound cardiac arrhythmia's and even asystole with the attack of pain. The presence of such phenomena guarantees that the pain syndrome involves this nerve. The diagnosis can be confirmed by the cessation of pain when this nerve is blocked at the jugular foramen or when topical anesthesia of the pharynx stops the pain.

Treatment

"The pharmacologic management is the same as that for tic douloureux of the trigeminal nerve. When medical management fails, suboccipital craniectomy with exploration of the glossopharyngeal nerve is indicated. If a compressing blood vessel is found it can be mobilized, and the pain usually stops without any loss of nerve function. When no structural pathology can be identified, the glossopharyngeal nerve should be Sectioned. In such a case it is wise to Section the upper fibers of the vagus nerve as well, because they can also be involved in the pain syndrome. When rhizotomy is unsuccessful, which happens rarely, the medial aspect of the descending tract of the trigeminal nerve can be Sectioned to produce loss of pain and temperature sensation in the pharynx.

"A percutaneous technique of glossopharyngeal neurolysis has been described, but it has not been widely used because of cardiovascular and laryngeal complications. "

 

Trigeminal Neuralgia, aka Tic douloreaux  or  TN
&
Temporomandibular  Joint aka TMJ  Eventually Cancer.This website is about Brian Nelson's fight with a parotid (salivary) gland tumor. It started out with the symptoms of  Trigeminal Neuralgia, aka Tic douloreaux  or  TN & Temporomadibular Joint aka TMJ Click Here to see my other record file at IAmFightingCancer.com  Bookmark this page now!  
 
Scan down to read my very lengthy and detailed web journal. Call me if I can help you. 713-467-3025 Brian
Hi,
1. CLICK for the very low priced Web Hosting service I use. Click Here for Prices or
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Brian
Signature Card For:                 Brian Nelson    31 Gessner Rd. , Houston, TX  77024
Tel. 713-467-3025 (Refers to my cell)      Fax 713-467-3192        
Click here to e-mail me.

www.NelsonIdeas.com
       Make a difference in the world!  "Idea Possibility Consulting"
www.BrianNelsonConsulting.com    There are so many new ways to make more profit. 
www.PartyTentCity.com 
                                The best modular party tent you can buy!
www.IamFightingCancer.com   Brian's story on Cancer and TN.  Post your Cancer story!
77 From: http://www.gwc.maricopa.edu/class/bio201/cn/cranial.htm Go to this site to click on 12 cranial nerves which light up when you put your cursor over it.

Cranial Nerves:
Review Info
 
 
 
 

  There are 12 pairs of cranial nerves.
  Olfactory I
  Optic II
  Oculomotor III
  Trochlear IV
  Trigeminal V
  Abducens VI
  Facial VII
  Auditory (vestibulocochlear) VIII
  Glossopharyngeal IX
  Vagus X
  Spinal Accessory XI
  Hypoglossal XII
 

To help memorize each, a mnemonic is often used by students such as . . .
"On Old Olympic Towering Tops A Finn And German Viewed Some Hops"
Cranial Nerve:        Major Functions:
I Olfactory        smell
II Optic        vision
III Oculomotor        eyelid and eyeball movement
IV Trochlear        innervates superior oblique
turns eye downward and laterally
V Trigeminal        chewing
face & mouth touch & pain
VI Abducens        turns eye laterally
VII Facial        controls most facial expressions
secretion of tears & saliva
taste
VII Vestibulocochlear
(auditory)
       hearing
equillibrium sensation
IX Glossopharyngeal        taste
senses carotid blood pressure
X Vagus        senses aortic blood pressure
slows heart rate
stimulates digestive organs
taste
XI Spinal Accessory        controls trapezius & sternocleidomastoid
controls swallowing movements
XII Hypoglossal        controls tongue movements

 

78
Trigeminal neuralgia  From http://www.healthatoz.com/healthatoz/Atoz/ency/trigeminal_neuralgia.jsp
 

 

Definition

Trigeminal neuralgia is a disorder of the trigeminal nerve (the fifth cranial nerve) that causes episodes of sharp, stabbing pain in the cheek, lips, gums, or chin on one side of the face.

Description

The trigeminal nerve, which is divided into three branches, is responsible for chewing, for producing saliva and tears, and for sending facial sensations to the brain. When this nerve breaks down for some reason, it can trigger brief but agonizing sizzles of pain on one side of the face.

This condition is unusual in those under age 50 and more often occurs after 70. Women are three times more likely to have the condition than are men. When trigeminal neuralgia does occur in younger people, it is often associated with multiple sclerosis.

The pain, while brief, is so severe that the sufferer often can't do anything else while the attack lasts. People with this pain often wince or twitch, which is where trigeminal neuralgia gets its French nickname tic douloureux, meaning "painful twitch."

Causes and symptoms

The origin of trigeminal neuralgia is not certain, but scientists believe it may be caused by degeneration, pressure, or irritation of the trigeminal nerve. Some doctors believe the pain may be triggered by pressure from a nearby abnormally-formed artery lying too close to the nerve.

Any part of the three branches of the trigeminal nerve may be affected. Neuralgia of the first branch leads to pain around the eyes and over the forehead; the second branch causes pain in the upper lip, nose and cheek; the third branch causes pain on the side of the tongue and lower lip.

The first episodes are usually fairly mild and brief, and it may be minutes, hours, or weeks before the next attack. However, attacks tend to occur in clumps that may last for weeks at a time. As the sufferer ages, the episodes become more frequent and painful, until the person begins to live in constant fear of the next one.

The momentary bursts of pain usually begin from the same spot on the face each time. The pain can be triggered by touching the area, washing, shaving, eating, drinking, or even talking. Even a cool breeze across the face can set off an attack. Pain is more severe at the ends of the affected nerve, especially over the lip, chin, nostrils, or teeth.

Diagnosis
Diagnosis is usually made by eliminating other problems that could cause similar pain in teeth, jaw, head, or sinuses. Because patients with the condition tend to avoid trigger points, avoiding chewing, shaving, touching or washing their faces can be a clue to diagnosis of trigeminal neuralgia.

Treatment

It is not easy to treat trigeminal neuralgia. Pain can be suppressed by a range of medicines, including the anti-epilepsy medicines carbamazepine (Tegretol) or phenytoin (Dilantin). These drugs slow down the nerve signals at certain nerve terminals, which eases the pain. However, these drugs cause a wide range of side effects, including nausea, dizziness, drowsiness, liver problems, and skin allergies. Some people develop resistance to the drugs or they can't tolerate the high dosage needed to control the discomfort. If the medicines are stopped, the pain usually returns.

If drug treatment fails, surgical treatment to block pain signals from the nerve may be effective. Radio-frequency waves, gamma rays, or glycerol injections can deaden the nerve (and hence the pain). An operation that frees the nerve from whatever is compressing it (blood vessel or tumor) can permanently relieve pain, but this major neurosurgical procedure carries its own risks and complications. Alternatively, a new procedure seeks to place a cushioning sponge between the nerve and a pulsating artery wrapping around it to soothe the irritated nerve.

Prognosis

Although the pain is momentarily incapacitating, it's not life-threatening. As the person ages, the attacks can be expected to occur more and more frequently.

Prevention

While the condition itself can't be prevented, there are a number of things patients can do to avoid triggering attacks:

 

  • wash with cotton pads and warm water over the face

     

     

  • rinse the mouth with water after eating, if toothbrushing triggers pain

     

     

  • eat and drink food and beverages at room temperature

     

     

  • chew on the unaffected side

     

     

  • eat soft foods, if eating is becoming a problem

 

79  From http://swnt240.swmed.edu/swneurosurg/tn.htm

Trigeminal Neuralgia and
Vascular Compression Syndromes

 

Trigeminal neuralgia is a face pain syndrome characterized by electric like shock pain that is generally on one side of the face, comes in waves and is often triggered by light touch, brushing of teeth, eating or even talking. It is often misdiagnosed as dental pain or jaw pain and can even be dismissed as "nothing" by inexperienced physicians.

Trigeminal neuralgia is thought to be caused by compression of the nerve that supplies sensation to the face by an aberrant loop in a normal brain blood vessel. Treatment options include observation, medication and various types of surgical procedures to alleviate the pain. No one treatment is right for everyone so we feel it is best to be treated in an environment where multiple treatment modalities are available. Results of the surgical treatment of trigeminal neuralgia are linked to the experience of the surgeon. We believe it is important to only undergo treatment by a neurosurgeon who has familiarity with the disease.

Other vascular compression syndromes exist.  Trigeminal neuralgia is compression of the fifth cranial nerve and results in pain. Compression of the seventh cranial nerve causes hemifacial spasm, a twitching of one side of the face that flares and remits during the course of a day.  Glossopharyngeal neuralgia is compression on the ninth nerve and causes a pain similar to trigeminal neuralgia but in the back of the throat rather then on the face. These other compression syndromes also respond to therapy.

Face pain can be caused by things other then trigeminal neuralgia. Traumatic nerve injury, dental pain, jaw pain and stroke can all cause various types of atypical face pain. The treatment of these types of face pain depends on making the proper diagnosis and customizing therapy. Treatment also needs to be directed to the secondary effects of chronic pain.

80  Osteonecrosis of the Jaw  From http://www.diagnose-me.com/cond/C547513.html
   
     
   

Neuralgia-inducing Cavitational Osteonecrosis (NICO) has been described in medical literature since 1976 and is known under a number of names including: Ratner bone cavities, alveolar cavitational osteopathosis, Robert's bone cavity, trigger point bone cavity, interference field and, most commonly, NICO. In cases of NICO it is claimed that small areas of bone in the upper or lower jaw become infected or inflamed and die, producing neuralgia-like pain. Most often, no sign of inflammation appears on X-ray. NICO is said to appear after tooth extraction, jaw surgery, endodontic therapy or crown preparation and is speculated to be the result of a long-standing low-grade infection.

The pain felt is constant and is often burning and cramping, much like atypical facial pain symptoms. Usually there are trigger points immediately over the areas of infected jawbone that will produce pain when pressed. NICO can cause "referred pain" in that the neuralgia-like symptoms are "referred" to other parts of the face, intraoral cavity and head.

Some cases of NICO appear to be caused or aggravated by infection. Others speculate that minor trauma from extractions, root canal and other dental procedures are common initiators of NICO but believe this only happens in people already susceptible because of a pre-existing blood clotting disorder. Some believe that NICO can develop when blood vessels are injured in the area, resulting in poor circulation which in turn can lead to bone death.

It is difficult to diagnose this problem as the pain symptoms often are similar to other conditions such as Myofascial Pain Disorder (MPD), Temporal Mandibular Joint (TMJ) problems, atypical facial pain, trigeminal neuralgia, phantom toothache, or headache. X-rays of the jawbone most often appear normal. However, a bone biopsy of the affected area can show positive signs of jawbone inflammation.

Discussion
NICO is not generally accepted as a cause of Trigeminal Neuralgia by most medical and dental professionals. It is possible that NICO is involved in some cases of facial neuralgia, especially atypical facial pain. One long-term study has reported considerably or totally reduced pain in 74% of facial neuralgia patients who had jawbone curettage. However, the pain returned for about 30% of these patients, of whom most had been diagnosed with either TN or atypical facial pain.

In dental circles there appears to be two distinct schools of thought on NICO. Some medical and dental professionals consider NICO a controversial diagnosis. Not only do they not consider it a possible cause of trigeminal neuralgia or other facial neuralgias, they also doubt the condition exists as a disorder. They point to data suggesting bone cavitations are found routinely in cadaver jawbones, casting doubt on the theory that bone cavities cause facial neuralgias.

Other dentists believe NICO is the culprit in many facial pain syndromes and that these painful conditions can be cured by jawbone curettage (scraping and removing infected tissue). They point to studies that show a high success rate for jawbone curettage. Some of these dentists believe that root canals and mercury fillings are partly responsible for NICO.

Signs, symptoms & indicators of Osteonecrosis of the Jaw:

Symptoms - Nervous   Shooting/having constant facial pain

Risk factors for Osteonecrosis of the Jaw:

Circulation   Hypercoagulation (Thickened Blood)

Osteonecrosis of the Jaw can lead to:

Nervous System   Trigeminal Neuralgia / Facial Pain

Recommendations and treatments for Osteonecrosis of the Jaw:

Surgery/Invasive   Surgery
  The only known treatment for NICO is jawbone curettage, in which the jawbone is opened, the infected area drilled out, and the bone biopsied to confirm the presence of inflammation or infection. Often the bone cavity is packed with antibiotics such as teramyacin. A course of antibiotic treatment may be prescribed. Jawbone curettage is not currently done routinely, and it is too early to say whether or not it will ever become generally accepted.
Trigeminal Neuralgia, aka Tic douloreaux  or  TN
&
Temporomandibular  Joint aka TMJ  Eventually Cancer.This website is about Brian Nelson's fight with a parotid (salivary) gland tumor. It started out with the symptoms of  Trigeminal Neuralgia, aka Tic douloreaux  or  TN & Temporomadibular Joint aka TMJ Click Here to see my other record file at IAmFightingCancer.com  Bookmark this page now!  
 
Scan down to read my very lengthy and detailed web journal. Call me if I can help you. 713-467-3025 Brian
Signature Card For:                 Brian Nelson    31 Gessner Rd. , Houston, TX  77024
Tel. 713-467-3025 (Refers to my cell)      Fax 713-467-3192        
Click here to e-mail me.

www.NelsonIdeas.com
       Make a difference in the world!  "Idea Possibility Consulting"
www.BrianNelsonConsulting.com    There are so many new ways to make more profit. 
www.PartyTentCity.com 
                                The best modular party tent you can buy!
www.IamFightingCancer.com   Brian's story on Cancer and TN.  Post your Cancer story!
81 From http://www.ninds.nih.gov/health_and_medical/disorders/trigemin_doc.htm
NINDS Trigeminal Neuralgia Information Page
Synonym(s):  Tic Douloureux
Reviewed  05-29-2001   Get Web page suited for printing
Email this to a friend or colleague
Table of Contents (click to jump to sections)

What is Trigeminal Neuralgia?
Is there any treatment?
What is the prognosis?
What research is being done?

Organizations
Related NINDS Publications and Information

What is Trigeminal Neuralgia?
Trigeminal neuralgia, also called tic douloureux, is a condition that affects the trigeminal nerve (the 5th cranial nerve), one of the largest nerves in the head. The trigeminal nerve is responsible for sending impulses of touch, pain, pressure, and temperature to the brain from the face, jaw, gums, forehead, and around the eyes. Trigeminal neuralgia is characterized by a sudden, severe, electric shock-like or stabbing pain typically felt on one side of the jaw or cheek. The disorder is more common in women than in men and rarely affects anyone younger than 50. 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. The attacks may come and go throughout the day and last for days, weeks, or months at a time, and then disappear for months or years.

Is there any treatment?
Treatment for trigeminal neuralgia typically includes anticonvulsant medications such as carbamazepine or phenytoin. Baclofen, clonazepam, gabapentin, and valproic acid may also be effective and may be used in combination to achieve pain relief. If medication fails to relieve pain, surgical treatment may be recommended.

What is the prognosis?
The disorder is characterized by recurrences and remissions, and successive recurrences may incapacitate the patient. Due to the intensity of the pain, even the fear of an impending attack may prevent activity. Trigeminal neuralgia is not fatal.

What research is being done?
Within the NINDS research programs, trigeminal neuralgia is addressed primarily through studies associated with pain research. NINDS vigorously pursues a research program seeking new treatments for pain and nerve damage with the ultimate goal of reversing debilitating conditions such as trigeminal neuralgia. NINDS has notified research investigators that it is seeking grant applications both in basic and clinical pain research.

82  From: http://www.tna-support.org/newlook/conference_files/2nd%20Natl%20Conf/Dental.htm

Report of the Trigeminal Neuralgia Association
Second National Conference,

November 11-15, 1998
Orlando FL

TN and Dental Problems

Dental problems loom large for anyone with TN because the trigeminal nerve goes to both face and teeth. Some people are initially misdiagnosed by a dentist and have unnecessary root canals and/or extractions. Later on, major dental work can make the pain of TN worse or it can end a remission.

Dentist Brian D. Fuselier: It's true that TN is often diagnosed only after the patient has had a number of unnecessary dental procedures. My colleagues and I are trying to educate dentists to consider TN when they're diagnosing facial pain.

Dentists assume that when prodding a tooth produces severe pain, it is usually caused by pulpitis (inflammation of the pulp or nerve of the tooth) and the appropriate treatment is a root canal. If that doesn't help, the dentist may do a second root canal on another tooth.  Eventually, the patient may have one or more teeth extracted. All this dental treatment may be unnecessary.

The first thing a dentist should do in diagnosing pain is to make sure the patient has a true dental problem. If the pain is not dental, it could be caused by a number of different conditions, including TN. To make a diagnosis, the dentist should ask questions about the quality of the pain - is it throbbing, stabbing, electrical, continuous, etc. - and about its intensity, duration and frequency, as well as its location.

Dentist Parker E. Mahan: Dentists differentiate between types of pain by taking an extensive medical history and examining the teeth, jaw muscles, salivary glands, blood vessels, mucus membranes, and temporomandibular joints. There are several facial pain syndromes that are sometimes confused with TN. They include:

Atypical odontalgia, or atypical toothache: It's atypical because X-rays show nothing wrong with the tooth but it hurts. This often occurs in 30- to 50-year-old women who are depressed. However, the pain is real.

There are a number of theories about the cause of it. Some suggest that the disorder originates in the blood vessels or the sympathetic nervous system. When patients take a tricyclic antidepressant like imipramine (Tofranil) for three-toeight weeks, half find that the pain goes away.

Myofascial pain dysfunction (MPD):  People who clench their teeth repeatedly while they sleep (a problem called bruxism) can develop pain in the muscles on the sides of the face. Hard knots appear within the muscles; squeezing a knot produces shooting pain. If a dentist injects a local anesthetic into these knots, they become soft. The injection disrupts the muscle, but it heals in three weeks. To prevent the pain from returning after that, it's necessary to prevent bruxism, perhaps with a bite splint worn at night.
 
 
Before doing a root canal, should a dentist use Tegretol to make sure the patient doesn't have TN? (If facial pain is relieved by Tegretol, that strongly suggests that it may be caused by TN.)

Dr. Fuselier: If a