My Trigeminal Neuralgia Story Directory.  See 24 stories below on Trigeminal Neuralgia Facial Pain in videos and website story.

8 min 42 second pain  slide show below.

 
Trigeminal Neuralgia Facial Pain Slide Show TN TNA Tic  4153 views.

Welcome,  THIS WEBSITE IS DESIGNED TO HAVE EACH TRIGEMINAL NEURALGIA  patient tell  there story from the beginning of the problem to the current status which is understandably changing daily as the body processes more of the pain. My personal story is very long and and be seen at  www.IamFightingCancer.com   To seen some of the multiple TN stories on the net go to.

MyTrigeminalNeuralgia.com/Multiple-Stories/On-TN.html

http://www.MyTrigeminalNeuralgiaStory.com/HoustonSupportGroup/Meeting.html

www.MyTrigeminalNeuralgiaStory.com/Inside
EditionVideo/TN.wmv
 
Brian Nelson, Owner
Webpage Marketing Consultant 
31 Gessner Rd. ,  Houston, TX 77024
713-467-3025  Click: E-mail me
 You can find this site again  by typing in the  Google search engine  the unique word "1yrotSNTyM"  which is  OR "MyTNStory1 " backwards.

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Directory of Video Sites
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Click Brian Nelson's www.PartyTentCity.com for party tents, canopies and awnings. Today's Sale 26'x40' Tarp.   Silver. Regular price is $104.00. With this ad it is on sale for only $88.00. Shipping is $15. No charge for shipping if tarp is picked up at  31 Gessner Rd.  in Houston, TX  77024  Use PayPal to Brian@NelsonIdeas.com or Call Brian 713-467-3025.  
 Blue Box 1 Contact Brian at 31 Gessner Rd. Houston, TX  77024 Tel. 713-467-3025 Cell 713-927-4479 Click: E-mail me 
 www.IamFightingCancer.com   Bookmark this page now!   Anything Internet   
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  09/24/2009 02:35 PM -0500
 

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 Directory of Sites
 Blue Box 2  Brian Nelson

 Do you need a party tent of white or silver tarp? Go to www.PartyTentCity.com or to see all my links go to:  http://www.PartyTentCity.com/PTC/Websites.html

Today's  special sale: Business is slow. Call me right now while this include page is up and get a 23% discount off any www.PartyTentCity.com  order.  No charge for shipping if picked up at  31 Gessner Rd.  in Houston, TX  77024 Use PayPal to Brian@NelsonIdeas.com or Call Brian 713-467-3025. http://www.NelsonIdeas.com/Directory-All-Websites/Alphabetical.html
 Blue Box 2  Bookmark this page now!  
 Contact Brian at 31 Gessner Rd. Houston, TX  77024 Tel. 713-467-3025 Cell 713-927-4479 Click: E-mail me 
 www.IamFightingCancer.com   
 

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 You are at: http://www.MyTrigeminalNeuralgiaStory.com/   ud 08/29/2009 10:08 AM -0500 Bookmark this page now!

Misspelled words used to find this page 1 of 3. 
  Page  Alt Tags 6,   Trigeminal Neuralgia Minneapolis TN Pain Personal Story,  Balloon Compression Mentor, dysesthesia, bad feeling constant spasm. excruciating pains, Henry, Pneumonia Electrical Shocks, Shirley, Shelly  Wilson, Support Group, Education, Association, Stabbing, Jolts, Suicide Disease, Neuropathic, rare Disorder, Treatment, destructive surgery, Procedure, Microvascular Decompression, tic douloureux Marge Prietz
Patient Pain  Type Pain Started Cause of Pain  or Treatments Tried Address of Website

1 Brian Nelson

Electrical Shocks Left  Side

May 2004

Tumor Parotid  Salivary Gland
 http://www.MyTrigeminalNeuralgiaStory.com/BrianNelson/TN1.html

http://www.IamFightingCancer.com

 

 

 

 

 

 

 

 

 

 

 

 

2  My Trigeminal Neuralgia Template  http://www.MyTrigeminalNeuralgiaStory.com/PersonalTemplate/TN2.html
3   Shirley H 2004 http://www.MyTrigeminalNeuralgiaStory.com/ShirleyH/TN3.html
4 SandiW 2005 http://www.MyTrigeminalNeuralgiaStory.com/SandiW/TN4.html Atypical Facial Pain.
5 Charlotte McLaughlin  1992 http://www.MyTrigeminalNeuralgiaStory.com/CharlotteMcLaughlin/TNPatient.html
6 Molly Harker http://www.MyTrigeminalNeuralgiaStory.com/MollyHarker/TN6.html 
7 Erin http://www.MyTrigeminalNeuralgiaStory.com/Erin/TN7.html
8  
9  
10  

 

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4 Youtube Video Marge Prietz  1 of 2 Trigeminal Neuralgia 1972 to 2007 Click on the arrow. 

Electrical Shocks
Right  Side

1972  2 MVDSBlood Vessels Intertwined With Nerves in the Brain.
5 Youtube Video Marge Prietz  2 of 2 Trigeminal Neuralgia 1972 to 2007 Click on the arrow. 

Electrical Shocks
Right  Side

1972
 2 MVDSBlood Vessels Intertwined With Nerves in the Brain.
5 YouTube Videos  Jennifer

322 Views

Video started
4-20-07 Trigeminal
Neuragia and Bells Pals  Also has Bipolar Disorder.		 Jennifers Statement on Youtube. Click Here LIghtening Type Pain on the left side of her face 
 
 
6
YouTube Videos Dr. Report  Johns Hopkins Hospital. 		Dr Benjamin Carson at Johns Hopkins
 
7 Video 1 of 6 is  4 Minutes 56 Sec.  Neurosurgeon  Dr. Rob Parrish speaks to the Houston Trigeminal Neuralgia Support Group about the Microvascular Decompression Operation better known as the MVD. Click here or on the arrow in the picture.  
8 Video 2 of 6 is 5 Minutes 3 sec.   Neurosurgeon  Dr. Rob Parrish speaks to the Houston Trigeminal Neuralgia Support Group about the Microvascular Decompression Operation better known as the MVD.
 Click here or on the arrow in the picture. 		 
9 Video 3 of 6 is 5 Minutes 34 sec.  Neurosurgeon  Dr. Rob Parrish speaks to the Houston Trigeminal Neuralgia Support Group about the Microvascular Decompression Operation better known as the MVD.
Click here or on the arrow in the picture. 		 
10 Video 4 of 6 is 5 Minutes 7 sec. Neurosurgeon  Dr. Rob Parrish speaks to the Houston Trigeminal Neuralgia Support Group about the Microvascular Decompression Operation better known as the MVD.
Click here or on the arrow in the picture. 		 

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11 Video 5 of 6 is 4 Minute 38 sec.  Neurosurgeon  Dr. Rob Parrish speaks to the Houston Trigeminal Neuralgia Support Group about the Microvascular Decompression Operation better known as the MVD.
Click here or on the arrow in the picture. 		 
12 Video 6 of 6 is  2 Minutes 12 sec.  Neurosurgeon  Dr. Rob Parrish speaks to the Houston Trigeminal Neuralgia Support Group about the Microvascular Decompression Operation better known as the MVD.
Click here or on the arrow in the picture. 		 

Enjoy the videos! Note: These video clips are created in Windows Media Player and optimized for fastest loading time. If click on on the movie image below does not work please go to http://www.texastna.org/videos.html and click on the icon there.

14TNA V13. Click hre for this video everyone is talking about! See a frank and revealing 5 minute video that includes a diagnosis of Trigeminal Neuralgia and the subsequent surgery and outcome of a Microvascular Decompression, MVD. See Dr. Johnathan White and senior citizen patient who has been in significant pain. See how this operation in the brain has reduced his pain. He was ready was die rather than to have to live with this staggering pain. He would not have minded if he died on the operating table. 
He has just a few minor twitches now. He was depressed without hope. Now he may live another 7 or 8 years. he is excited about life once again.
14

 

Occipital Neuralgia Part II

2 of 2. 6 minutes 51 Seconds.  This is the video everyone is talking about! See a frank and revealing 5 minute video that includes a diagnosis of Trigeminal Neuralgia and the subsequent surgery and outcome

 

  

 Click for more on   Stimulators and  Neurovascular Intervention   http://www.MyTrigeminalNeuralgiaStory.com/Stimulators/NeurovascularIntervention.html

See the video on occipital neuralgia pain reduction using a Motor Cortex Stimulator in his head ":

NEW! Severe Occipital Neuralgia - Bobby Sorrell  Starkville, Mississippi suffers from an almost incapacitating disease. See how surgery changed his life! Click the Black Camera icon with red wording on: http://www.texastna.org/videos.html  It looks like this:

 1 of 2. 6 min. 48 seconds.  NEW! Occipital Neuralgia - Bobby Sorrell suffers from an almost incapacitating disease -- see how surgery changed his life! 
 
Bobby Sorrell and his wife Amy give you a first... (more)
Added: October 03, 2007 Bobby Sorrell and his wife Amy give you a first hand look into the world of an Occipital Neuralgia patient and the surgical option they choose to improve their situation. Filmed for the Texas Trigeminal Neuralgia Support Group in association with TNA and UT Southwestern Medical Center.

People involved: Shelly Wilson,  Dr. Tony Whitworth, Neurosurgeon. UT Southwestern, Dallas, TX.  Changes  were made from Opiod and Morphine Medication to a Motor Cortex Stimulator to curb extreme pain. IT is powered by a permanent battery from Medtronic No. 3771 in  a pocket of skin just under Bobby's collar bone.  Bobby is pain free now  by the number of pulses per second regulated by him. Main support  Wife, Amy and Patsy, Lessie and will Sorrell.  Julie Carlsen Ph. D. MSN, MSA  is the Therapy Consultant Medtronic Neurological "  Medtronic, Inc.
 "You Performed a Miracle with me" Bobby Sorrell said after the surgery.

2  Texas TNA Support Website http://www.texastna.org/videos.html
TNA 15. Just who is Shelly Wilson? Dr. Jonathan White and Dr. Micheal Pasternak conversation. Shelly Wilson is a multitalented compassionate organizer of very large national events that involve hundreds of dynamic time sensitive projects.What a blessing TNA is to have her volunteering her time to help so many people.
16 TNA V15. What can TNA do for you? Shelly Wilson speaks with Dr. Pasternak about TNA’s role and mission How can the Trigeminal Neuralgia Assoication help you.
 The picture on the right is from the Regional Patient Conference and CE Course on Trigeminal Neuralgia and Chronic Facial Pain Held at NYUCD
  TNA conference organizers, from left: Dr. Michael Pasternak, President of the Trigeminal Neuralgia Association (TNA); Ms. Shelly Wilson, conference coordinator; and TNA Medical Advisory Boad members Dr. Jeffrey Cohen, Dr. Peter Jannetta (Chairman of the Board), and Dr. David A. Sirois.
17 TNA V16 2006 National Conference in Portland Oregon in September 14-18, 2006 Slideshow (high quality, slower load) Slides Taken by Brian Nelson
18 TNA V17. 2006 National Conference in Portland Slideshow (low quality, faster load) Slides Taken by Brian Nelson

Enjoy the videos! Note: These video clips are created in WindowsMedia Player and optimized for fastest loading time.

19 Trigeminal Neuralgia
 http://youtube.com/watch?v=JZEigMd4GpY
A patient suffering from Trigeminal Neuralgia (extreme facial pain) has breakthrough neurosurgery, microvascular decompression, to resolve the pain & restore quality of life.~Detroit Medical Center

 

Featuring Dr. Ken Casey Detroit Medical Center
 

Added: October 29, 2007  Views: 7,208
 

Tags: 
 
 
20  The Wellmont Connection - Trigeminal Neuralgia 
Cyberknife

http://www.youtube.com/watch?v=MhaFZDMEgog

Added: January 21, 2008 (Less info)
Elizabeth suffered from trigeminal neuralgia, a rare nerve disorder that caused excruciating pain in her face. However, a new treatment with Wellmont Health System's CyberKnife cured her condition and restored her quality of life
Category:  Education

 

  
21  Neuralgia del Trigemino. Janetta 1.mov

Clear video but not much else. No sound or English text.

http://www.youtube.com/watch?v=qYzgeuQCiw8&NR=1

Videos resúmenes de algunas intervenciones realizadas en el Servicio
Translation: Spanish » English

Videos summaries of some statements made in Service
  

22 Patient Story Blog / April - Trigeminal Neuralgia

The Story of April  on the UCLA  Health System Network.

It all started a year and a half ago, a couple of weeks before a family trip to Las Vegas.  I felt dental pain in my left lower jaw and went to the dentist.  Dental X-rays did not show any problems, but I had begun grinding my teeth so the dentist made me a bite guard and gave me a prescription for Vicodin.  He also sent me to an endodontist, but there was no indication that I needed a root canal. 

By the end of our trip, I was in such pain that it was unbearable to eat, talk, or even smile.  When we returned home to LA, the dentist suggested doing a root canal "to see" if that would rid me of my pain.  I said "no thanks."  But I was still in pain so I went to see another dentist who specialized in TMJ.  He did a panoramic X-ray of my mouth, which came back normal.  Upon examination, it was determined that I had a slight case of TMJ and needed a second (very expensive and mostly not covered by insurance) bite guard made.  It didn't help. 

Several months later, the pain intensified.  My regular dentist still could not determine the source of pain and referred me to a different endodontist.  By then, I had done my own research and although I didn't display classic root canal problems, I thought perhaps I had a hairline fracture deep in my tooth.  I was so desperate for relief that I was open to, and proceeded to have, first one, then another root canal.  But the pain didn't go away. 

The constant pain was wearing me down and made it difficult to take care of my little ones (now ages 5 and 3).  Out of frustration and desperation, I googled my symptoms on the internet and came across something called "trigeminal neuralgia" (TN).  A family friend who is a neurosurgeon, Dr. Tony Feuerman, referred me to a neurologist, Dr. P.B. Andersson.  My MRI scans ruled out brain tumors and I began taking Lyrica, working up to 150 mg doses twice a day.  It helped take the edge of the pain at times, but it would always return. 

Around the New Year the pain started to worsen again, so my neurologist added a second medication, Carbatrol (200 mg twice a day).  I was already tired from the Lyrica, and the added medication increased my fatigue.  Three months later, the medication was deemed ineffective and my neurologist referred me to Dr. Antonio DeSalles, a Radiosurgery expert at UCLA.  Dr. DeSalles specializes in minimally invasive gamma knife (radiation) treatment, which involves partially deadening nerves with precise doses of radiation.  After reviewing my records, Dr. DeSalles said that gamma knife treatment was an option, but that based on my age and relatively good health he strongly recommended microvascular decompression surgery and referred me to Dr. Neil Martin, head of UCLA Neurosurgery.  Both my neurologist and neurosurgeon friend said that Dr. Martin is the "Best in the West" for this specialized procedure.

Dr. Martin explained the procedure and its possible side effects.  Basically, an incision is made and a nickel sized hole drilled in the skull.  Using microscopic instruments, Dr. Martin would locate, separate, and stop the compression of the blood vessels pressing against the trigeminal nerve (which was the cause of pain).  It's still hard to imagine that something happening inside my head was causing pain in my jaw. 

Microvascular decompression is low-risk major surgery and if successful, would completely cure me.  While the thought of undergoing brain surgery was scary, the thought of being pain and medication-free was more compelling.  Planning for a 2-4 week recovery time, I decided to schedule the procedure in early summer when my sister, a schoolteacher in Hawaii, could help me with the house and kids.  However, by the end of March, my pain was continuing to worsen and I could wait no longer.

On April 17, I underwent a six hour surgery.  Dr. Martin found and addressed three areas that were compressed.  During the initial recovery period, I was not able to fully appreciate being pain-free.  I experienced normal side-effects like headaches and double-vision.  But by the time I was off all medication and my sutures were removed, I started feeling better for the first time in awhile.  I still felt fatigue four weeks after surgery, but was comforted to learn that it would be a month or two before I felt 100% like myself.  It has now been just over two months and I am happy to report that I am fully recovered and that the constant, unbearable pain caused by TN is gone for good.

I am so very grateful for Dr. Martin (THANK YOU, DR. MARTIN) and his great expertise, patience, and precision.  He gave me my life back.  I can read to my kids again and joke with them (I told them that the doctor took out the grumpy bug).  Dr. Martin's staff (Jennifer, Antoinette and everyone) was so efficient and my admission and hospital stay went very smoothly.  The neuro-recovery ward nurse, Audry Hamill, was especially terrific.  I was discharged from the hospital on my birthday and she brought me a cake.  This gift was actually "the icing on the cake" since Dr. Martin's gift of making me pain-free was the best possible birthday present.

In hindsight, I wish I had done the surgery even sooner instead of hoping and waiting to see if the medication would eventually work (in a last ditch futile effort to avoid surgery, I even had a tooth extracted and now must face a dental implant).

I feel so fortunate to have a supportive husband and family (a great sister and the best sister-in-law) who helped with my kids and home in many times of need, and the friends who showed so much care and concern throughout my ordeal
23  Trigeminal Neuralgia Part I

An educational video about Trigeminal Neuralgia (A.K.A Tic Douloureux) and Microvacular Decompression, a procedure that can cure the crippling facial pain associated with Trigeminal Neuralgia. This video contains personal testimony from both P. Jeffrey Lewis,M.D.- the surgeon, and patients who have had the Microvascular Decompression Procedure. Also, live pictures & video from the actual procedure as viewed through the operating microscope are presented.

 

  Click here. Part 1  http://youtube.com/watch?v=4iQ1rqxrriA
 
video
i

 
24  Trigeminal Neuralgia Part 2

An educational video about Trigeminal Neuralgia (A.K.A Tic Douloureux) and Microvacular Decompression, a procedure that can cure the crippling facial pain associated with Trigeminal Neuralgia. This video contains personal testimony from both P. Jeffrey Lewis,M.D.- the surgeon, and patients who have had the Microvascular Decompression Procedure. Also, live pictures & video from the actual procedure as viewed through the operating microscope are presented.

 

  Click here. Party 2. http://youtube.com/watch?v=U_XO4ZGgwWY
 
video
iTags. Crippling  Facial  Pain  Cranial  Nerve  P.  Jeffrey  Lewis  Tic  Douloureux  Buffalo  Neurosurgery  Group  Minimally  Invasive

 
Trigeminal Neuralgia
Extreme
Facial
Pain
TN
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YouTube.
From
NelsonIdeas.com






Trigeminal Neuralgia
Extreme
Facial
Pain
TN
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Trigeminal Neuralgia
Extreme
Facial
Pain
TN
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Trigeminal Neuralgia
Extreme
Facial
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My Trigeminal Neuralgia Extreme Facial Pain TN Websites
 http:/./www.NelsonIdeas.com

Click Dental Education Trigeminal Neuralgia Extreme Facial Pain
http://www.NewMedicalDirectories.com/Trigeminal-Neuralgia-Dental/Dentist-Dentists.html
Click Trigeminal Neuralgia Patient Painful-Stories
http://www.BrianNelsonConsulting.com/trigeminal-neuralgia-tn/patient-painful-stories.html
Click My Trigeminal Neuralgia (TN) Story only http://www.PartyTentCity.com/mytnstory.html

Click My Story on TN Brian N
http://www.PartyTentCity.com/trigeminal-neuralgia-tn-tmj-my-story/directory.html

Click Trigeminal Neuralgia Slide Show Story of Pain http://www.NewMedicalDirectories.com/Trigeminal-Neuralgia-Slide-Show/Draft.html

Click Medical Data Base  Medical Costs More Expensive  Due to Non Use of Technology http://www.briannelsonconsulting.com/medical-data-base/faq-info.html

Click MyTrigeminal Neuralgia Story Directory http://www.MyTrigeminalNeuralgiaStory.com

Click Slide Show Draft for New TN Patients. http://www.newmedicaldirectories.com/Trigeminal-Neuralgia-Slide-Show/Draft.html

Click-Trigeminal Neuralgia Assn Page 1
http://newmedicaldirectories.com/Trigeminal-Neuralgia-Association/TN-Facial-Pain.html

Click-Trigeminal Neuralgia Assn Page 2  
http://newmedicaldirectories.com/Trigeminal-Neuralgia-Association/TN-Facial-Pain-2.html

Click What is Trigeminal Neuragia? Portland,OR Slide Show
http://www.NewMedicalDirectories.com/Trigeminal-Neuralgia-Slide-Show/Draft.html

Click Trigeminal Neuralgia National Conference
http://www.NewMedicalDirectories.com/Trigeminal-Neuralgia-Slide-Show/Draft.html

Click Trigeminal Neuralgia  Brian's Journal Tic Douloureux (TN) FacialPain-Cancer
http://www.BrianNelsonConsulting.com/trigeminal-neuralgia-tn/faq-info.html
http://www.BrianNelsonConsulting.com/trigeminal-neuralgia-tn/faq-info.html

Click Page 1. Trigeminal Neuralgia http://www.BrianNelsonConsulting.com/trigeminal-neuralgia-tn/faq-info.html

Click Page 2 Trigeminal Neuralgia
http://www.briannelsonconsulting.com/trigeminal-neuralgia-tn/faq-info2.html

Click Page 3 Trigeminal Neuralgia
http://www.briannelsonconsulting.com/trigeminal-neuralgia-tn/faq-info3.html

Click Page 4  Trigeminal Neuralgia
http://www.BrianNelsonConsulting.com/trigeminal-neuralgia-tn/faq-info4.html

Click MyTrigeminal Neuralgia Stories Directory  
http://www.MyTrigeminalNeuralgiaStory.com/Index.html

Click Brian's TN Story Quck Version
http://www.MyTrigeminalNeuralgiaStory.com/BrianNelson/TN1.html

Click Shirley's Story Trigeminal Neuralgia  
http://www.MyTrigeminalNeuralgiaStory.com/ShirleyH/TN3.html

Click  Sand's Story TN
http://www.MyTrigeminalNeuralgiaStory.com/SandiW/TN4.html
Trigeminal Neuralgia
Extreme
Facial
Pain
TN
Websites insert.
YouTube.
From
NelsonIdeas.com






Trigeminal Neuralgia
Extreme
Facial
Pain
TN
Websites insert.


Trigeminal Neuralgia
Extreme
Facial
Pain
TN
Websites insert.

 

Trigeminal Neuralgia
Extreme
Facial
Pain
TN
Websites insert.

My Trigeminal Neuralgia Extreme Facial Pain TN Websites
 http:/./www.NelsonIdeas.com

Click Dental Education Trigeminal Neuralgia Extreme Facial Pain
http://www.NewMedicalDirectories.com/Trigeminal-Neuralgia-Dental/Dentist-Dentists.html
Click Trigeminal Neuralgia Patient Painful-Stories
http://www.BrianNelsonConsulting.com/trigeminal-neuralgia-tn/patient-painful-stories.html
Click My Trigeminal Neuralgia (TN) Story only http://www.PartyTentCity.com/mytnstory.html

Click My Story on TN Brian N
http://www.PartyTentCity.com/trigeminal-neuralgia-tn-tmj-my-story/directory.html

Click Trigeminal Neuralgia Slide Show Story of Pain http://www.NewMedicalDirectories.com/Trigeminal-Neuralgia-Slide-Show/Draft.html

Click Medical Data Base  Medical Costs More Expensive  Due to Non Use of Technology http://www.briannelsonconsulting.com/medical-data-base/faq-info.html

Click MyTrigeminal Neuralgia Story Directory http://www.MyTrigeminalNeuralgiaStory.com

Click Slide Show Draft for New TN Patients. http://www.newmedicaldirectories.com/Trigeminal-Neuralgia-Slide-Show/Draft.html

Click-Trigeminal Neuralgia Assn Page 1
http://newmedicaldirectories.com/Trigeminal-Neuralgia-Association/TN-Facial-Pain.html

Click-Trigeminal Neuralgia Assn Page 2  
http://newmedicaldirectories.com/Trigeminal-Neuralgia-Association/TN-Facial-Pain-2.html

Click What is Trigeminal Neuragia? Portland,OR Slide Show
http://www.NewMedicalDirectories.com/Trigeminal-Neuralgia-Slide-Show/Draft.html

Click Trigeminal Neuralgia National Conference
http://www.NewMedicalDirectories.com/Trigeminal-Neuralgia-Slide-Show/Draft.html

Click Trigeminal Neuralgia  Brian's Journal Tic Douloureux (TN) FacialPain-Cancer
http://www.BrianNelsonConsulting.com/trigeminal-neuralgia-tn/faq-info.html
http://www.BrianNelsonConsulting.com/trigeminal-neuralgia-tn/faq-info.html

Click Page 1. Trigeminal Neuralgia http://www.BrianNelsonConsulting.com/trigeminal-neuralgia-tn/faq-info.html

Click Page 2 Trigeminal Neuralgia
http://www.briannelsonconsulting.com/trigeminal-neuralgia-tn/faq-info2.html

Click Page 3 Trigeminal Neuralgia
http://www.briannelsonconsulting.com/trigeminal-neuralgia-tn/faq-info3.html

Click Page 4  Trigeminal Neuralgia
http://www.BrianNelsonConsulting.com/trigeminal-neuralgia-tn/faq-info4.html

Click MyTrigeminal Neuralgia Stories Directory  
http://www.MyTrigeminalNeuralgiaStory.com/Index.html

Click Brian's TN Story Quck Version
http://www.MyTrigeminalNeuralgiaStory.com/BrianNelson/TN1.html

Click Shirley's Story Trigeminal Neuralgia  
http://www.MyTrigeminalNeuralgiaStory.com/ShirleyH/TN3.html

Click  Sand's Story TN
http://www.MyTrigeminalNeuralgiaStory.com/SandiW/TN4.html

Scan Below This Blue Box for Site Data on Trigeminal Neuralgia
Blue Box 1 Scan Below

Click Brian Nelson's www.PartyTentCity.com for party tents, canopies and awnings. Today's Sale 26'x40' Tarp.   Silver. Regular price is $104.00. With this ad it is on sale for only $88.00. Shipping is $15. No charge for shipping if tarp is picked up at  31 Gessner Rd.  in Houston, TX  77024  Use PayPal to Brian@NelsonIdeas.com or Call Brian 713-467-3025.  
 Blue Box 1 Contact Brian at 31 Gessner Rd. Houston, TX  77024 Tel. 713-467-3025 Cell 713-927-4479 Click: E-mail me 
 www.IamFightingCancer.com   Bookmark this page now!   Anything Internet   
 http://www.NelsonIdeas.com/Directory-All-Websites/Alphabetical.html

  09/24/2009 02:35 PM -0500

21 Definitions of Trigeminal Neuralgia on the Web:
  • Sharp shooting lancinating pain found in the forehead, face or jaw region. The pain is usually on only one side of the face. It can sometimes be seen in the setting of multiple sclerosis. Treatment usually consists of medical therapy (the primary drug is Tegretol ). ..
     
  • Lightning-like, acute pain in the face caused by demyelination of nerve fibers at the site where the sensory (trigeminal) nerve root for that part of the face enters the brainstem.
    A painful condition caused by a disturbance in the function of the trigeminal nerve, which carries sensation from your face to your brain. The pain is similar to an electric shock.
    a disorder of the trigeminal nerve (a cranial nerve) that causes brief attacks of severe pain in the lips, cheeks, gums, or chin on one side of the face
    a condition which produces pain in the trigemenal nerve in the face.
    Paroxysmal pain in the face. Pain may be so severe that it causes an involuntary grimace or "tic". (Tic Douloureux).
  • a condition resulting from a disorder of the trigeminal nerve. Symptoms are headache and intense facial pain that comes in short, excruciating jabs.
    intense paroxysmal neuralgia along the trigeminal nerve
     
  • Trigeminal neuralgia is a neuropathic disorder of the trigeminal nerve that causes episodes of intense pain in the eyes, lips, nose, scalp, forehead, upper jaw, and lower jaw. Trigeminal neuralgia is considered by most physicians to be the most painful condition known to man, and has, in fact, been called the, "suicide disease," because this has been the choice of many people who were unable to have their pain controlled with medications or surgery.
22 What Is Trigeminal Neuralgia?

 

TN (Trigeminal Neuralgia) is a pain that is described as among the most acute known to mankind.  TN produces excruciating, lightning strikes of facial pain, typically near the nose, lips, eyes or ears.

It is a disorder of the trigeminal nerve, which is the fifth and largest cranial nerve.

TN (Trigeminal Neuralgia / tic douloureux) is a disorder of the fifth cranial (trigeminal) nerve that causes episodes of intense, stabbing, electric shock-like pain in the areas of the face where the branches of the nerve are distributed - lips, eyes, nose, scalp, forehead, upper jaw, and lower jaw.  By many, it's called the "suicide disease".  A less common form of the disorder called "Atypical Trigeminal Neuralgia" may cause less intense, constant, dull burning or aching pain, sometimes with occasional electric shock-like stabs.   Both forms of the disorder most often affect one side of the face, but some patients experience pain at different times on both sides.  Onset of symptoms occurs most often after age 50, but cases are known in children and even infants. Something as simple and routine as brushing the teeth, putting on makeup or even a slight breeze can trigger an attack, resulting in sheer agony for the  individual. Trigeminal neuralgia (TN) is not fatal, but it is universally considered to be the most painful affliction known to medical practice.  Initial treatment of TN is usually by means of anti-convulsant drugs, such as Tegretol or  Neurontin.  Some anti-depressant drugs also have significant pain relieving effects.  Should medication be ineffective or if it produces undesirable side effects, neurosurgical procedures are available to relieve pressure on the nerve or to reduce nerve sensitivity.  Some patients report having reduced or relieved pain by means of alternative medical therapies such as acupuncture, chiropractic adjustment, self-hypnosis or meditation.
23 NINDS Trigeminal Neuralgia Information Page
Synonym(s):   Tic Douloureux
Condensed from Trigeminal Neuralgia Fact Sheet
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
Additional resources from MEDLINEplus
What is Trigeminal Neuralgia?
Trigeminal neuralgia (TN), also called tic douloureux, is a chronic pain condition that causes extreme, sporadic, sudden burning or shock-like face pain that lasts anywhere from a few seconds to as long as 2 minutes per episode.  The intensity of pain can be physically and mentally incapacitating. TN pain is typically felt on one side of the jaw or cheek. Episodes can last for days, weeks, or months at a time and then disappear for months or years.  In the days before an episode begins, some patients may experience a tingling or numbing sensation or a somewhat constant and aching pain.  The attacks often worsen over time, with fewer and shorter pain-free periods before they recur.  The intense flashes of pain can be triggered by vibration or contact with the cheek (such as when shaving, washing the face, or applying makeup), brushing teeth, eating, drinking, talking, or being exposed to the wind.  TN occurs most often in people over age 50, but it can occur at any age, and is more common in women than in men.  There is some evidence that the disorder runs in families, perhaps because of an inherited pattern of blood vessel formation. Although sometimes debilitating, the disorder is not life-threatening.

The presumed cause of TN is a blood vessel pressing on the trigeminal nerve in the head as it exits the brainstem. TN may be part of the normal aging process but in some cases it is the associated with another disorder, such as multiple sclerosis or other disorders characterized by damage to the myelin sheath that covers certain nerves.

Is there any treatment?

Because there are a large number of conditions that can cause facial pain, TN can be difficult to diagnose.  But finding the cause of the pain is important as the treatments for different types of pain may differ.  Treatment options include medicines such as anticonvulsants and tricyclic antidepressants, surgery, and complementary approaches. Typical analgesics and opioids are not usually helpful in treating the sharp, recurring pain caused by TN.  If medication fails to relieve pain or produces intolerable side effects such as excess fatigue, surgical treatment may be recommended. Several neurosurgical procedures are available. Some are done on an outpatient basis, while others are more complex and require hospitalization. Some patients choose to manage TN using complementary techniques, usually in combination with drug treatment.  These techniques include acupuncture, biofeedback, vitamin therapy, nutritional therapy, and electrical stimulation of the nerves.

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.

Select this link to view a list of studies currently seeking patients.

Organizations

Trigeminal Neuralgia Association
925 Northwest 56th Terrace
Suite C
Gainesville, FL   32605
tnanational@tna-support.org
http://www.tna-support.org
Tel: 352-331-7009 800-923-3608
Fax: 352-331-7078
 		 IRSA (International RadioSurgery Association)
P.O. Box 5186
Harrisburg, PA   17110
office@irsa.org
http://www.irsa.org
Tel: 717-260-9808
Fax: 717-260-9809
 		 National Foundation for the Treatment of Pain
 P.O. Box 70045
Houston, TX   77270
NFTPain@cwo.com
http://www.paincare.org
Tel: 713-862-9332
Fax: 713-862-9346
American Chronic Pain Association (ACPA)
P.O. Box 850
Rocklin, CA   95677-0850
ACPA@pacbell.net
http://www.theacpa.org
Tel: 916-632-0922 800-533-3231
Fax: 916-632-3208
 		 American Pain Foundation
201 North Charles Street
Suite 710
Baltimore, MD   21201-4111
info@painfoundation.org
http://www.painfoundation.org
Tel: 888-615-PAIN (7246)
Fax: 410-385-1832
 

23B      What is Occipital Neuralgia?
Occipital neuralgia is a distinct type of headache characterized by piercing, throbbing, or electric-shock-like chronic pain in the upper neck, back of the head, and behind the ears, usually on one side of the head.  Typically, the pain of occipital neuralgia begins in the neck and then spreads upwards.  Some individuals will also experience pain in the scalp, forehead, and behind the eyes.  Their scalp may also be tender to the touch, and their eyes especially sensitive to light.  The location of pain is related to the areas supplied by the greater and lesser occipital nerves, which run from the area where the spinal column meets the neck, up to the scalp at the back of the head.  The pain is caused by irritation or injury to the nerves, which can be the result of trauma to the back of the head, pinching of the nerves by overly tight neck muscles, compression of the nerve as it leaves the spine due to osteoarthritis, or tumors or other types of lesions in the neck.  Localized inflammation or infection, gout, diabetes, blood vessel inflammation (vasculitis), and frequent lengthy periods of keeping the head in a downward and forward position are also associated with occipital neuralgia.  In many cases, however, no cause can be found.  A positive response (relief from pain) after an anesthetic nerve block will confirm the diagnosis.

What is the prognosis?

Occipital neuralgia is not a life-threatening condition.  Many individuals will improve with therapy involving heat, rest, anti-inflammatory mediations, and muscle relaxants.  Recovery is usually complete after the bout of pain has ended and the nerve damage repaired or lessened.

What research is being done?

The National Institute of Neurological Disorders and Stroke (NINDS) and other institutes at the National Institutes of Health conduct research related to pain and occipital neuralgia in their clinics and laboratories and support additional research through grants to major medical institutions across the country.  Much of this research focuses on understanding the basic mechanisms of pain and testing treatments in order to find better ways to treat occipital neuralgia.
23c     OCCIPITAL NEURALGIA
Other Cranial Neuralgias

Disclaimer.

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.

Occipital neuralgia is characterized by pain in the suboccipital region and in the back of the head. A large number of patients have muscle tension headaches in the same distribution, but few of these patients have a true neuralgic pain.

ETIOLOGY

....Known causes of neuralgic pains in this area include trauma to the greater or lesser occipital nerves, compression of these nerves or the upper cervical roots by arthritic changes in the spine, and tumors involving the 2nd and 3rd cervical dorsal roots.

SIGNS AND SYMPTOMS

Occipital neuralgia is characterized by continuous aching and throbbing pain on which shock-like jabs can be superimposed....The pain is not triggered, but pressure over the occipital nerves can lead to an exacerbation. Both physical and emotional tension are common precipitating factors.

DIAGNOSIS

The region of the pain clearly establishes the diagnosis: the difficult task is determined whether the nerve lesion is primary or secondary. Vascular pains (migraine in the posterior scalp, or cluster headaches in the anterior scalp and face) are usually characterized by discrete attacks of throbbing pain, often associated with nausea and vomiting and other autonomic phenomena. Migraine is often terminated by ergot alkaloids; neuralgic pains are not.

Muscle tension headaches are a variant of myofascial pain syndrome and are common. They are clearly stress-related. The patient usually has a long history of such headaches, which wax and wane over the years. Tender areas in the suboccipital muscles are frequently located by palpation.

Positive finding from neruologic examination lead to the suspicion of a structural lesion; roentgenography or CT scan assists in the diagnosis.

TREATMENT

Obviously, when occipital neuralgia has a structural basis, treatment is aimed at the cause. In most patients, however, treatment is symptomatic. If the pains resemble those of tic douloureux, a trial of anticonvulsants might be worthwhile. If they resemble those of atypical facial pain, a tricyclic antidepressant and a phenothiazine can be tried. Local nerve blocks can help to establish the diagnosis and sometimes provide even longer relief than the duration of the agent used. Some have advocated the injection of local anesthetics and steroids, but controlled studies of the outcomes of such treatments have not been undertaken.

Neurosurgeons have advocated sectioning of the 2nd and 3rd cervical roots or the greater and lesser occipital nerves. Information on the efficacy of these procedures is lacking; the vast majority of patients do not appear to require a surgical procedure.
23D  Occipital Neuralgia
 

Definition of Occipital Neuralgia

Occipital neuralgia is a term used to describe a cycle of pain-spasm-pain originating from the suboccipital area (base) of the skull that often radiates to the back, front, and side of the head, as well as behind the eyes.

Description of Occipital Neuralgia

The occipital nerves are two pairs of nerves that originate in the area of the second and third vertebrae of the neck. While most people's nerve roots originate in similar places on the spine, cadaver studies show a wide variety of differences between individuals as to the course of the nerves once they leave the spinal column. Often the nerves follow a curving course that passes through various muscles in the upper back, neck and head.

These nerves supply areas of the skin along the base of the skull and partially behind the ear. While the occipital nerves do not directly connect with structures within the skull itself, they do interconnect with other nerves outside of the skull and form a continuous neural network that can affect any given area through which any of the main nerves or their branch fibers pass.

Causes and Risk Factors of Occipital Neuralgia

Occipital neuralgia occurs more often in women than men. It can have many causes such as trauma (a direct blow or "whiplash"); spinal column compression; nerve lesions; localized infections or inflammation; gout; diabetes; blood vessel inflammation; and local tumors.

Commonly, the nerves are inflamed and sensitive because they are trapped within the muscles through which they pass. Muscle spasm and pain are often associated with nerve entrapment, which causes localized pain, spasm and muscle cramping.

Symptoms of Occipital Neuralgia

Symptoms include the following:

  • Headaches that are localized or following a "ram's horn" pattern on the side of the head, often starting in the upper neck or base of the skull. It can be one-sided or on both sides.
  • Scalp that is tender to the touch, often hypersensitive. Even brushing your hair can be a painful experience.
  • Pain or pressure behind the eyes. Eyes are very sensitive to light especially when the headache is present.

Diagnosis of Occipital Neuralgia

Many conditions can show symptoms similar to those found with occipital neuralgia. Your physician will take a complete medical history and perform a physical examination.

Treatment of Occipital Neuralgia

Treatment of occipital neuralgia may involve oral medications that are designed to reduce inflammation and spasms, localized therapeutic injections, physical therapy, massage, and heat.

Questions To Ask Your Doctor About Occipital Neuralgia

Is there evidence of a nerve entrapment?
What is the cause of occipital neuralgia?
Are further diagnostic tests needed?
What treatment options are there?
Can you prescribe medication to reduce the inflammation and spasms?
Is a cure possible?
24 An Alternate Strategy

Instead of waiting for the pain to become intractable or the medications toxic, an individual with trigeminal neuralgia has the option to request early surgery. This has a number of potential advantages:

· Avoid years of medication and intermittent pain

· Avoid facing surgery when old or infirm

· If the person has a vascular loop, early microvascular decompression will increase the possibility of a successful operation with decreased risk of recurrence (evidence suggests better outcomes and lower recurrence rate the shorter the interval between onset of symptoms and nerve decompression)

How To Find Out If You Have a Vascular Loop

The conventional MRI scans used to rule out the presence of a brain tumor or multiple sclerosis as a cause of a patients face pain are not adequate to visualize the trigeminal nerve or an associated blood vessel. Fortunately, the continued improvement in MRI neuro-imaging now makes it possible to visualize both. The technique, which is called 3-D volume acquisition, is performed with contrast injection and utilizes thin cuts (0.8mm), without gaps similar to what was developed for MRI angiography and venography. The trigeminal nerve is easily visualized in the axial plane when the MRI series is centered at the midpoint of the fourth ventricle. To ensure an adequate evaluation, the nerve should be seen on three adjacent cuts. Early studies indicate that when an offending vessel is present it will be detected 80% of the of the time. With continued imaging improvements this percentage will definitely increase. Click here for UCSD Trigeminal Neuralgia Sequence Parameters for Seimens and GE MR Scanners.

 Surgical Options: Non-Destructive Procedures

The only non-destructive procedure which reliably relieves the symptoms of Trigeminal Neuralgia is Microvascular Decompression (MVD). This involves surgical exploration with the operating microscope and visualization of the junction where the Trigeminal nerve enters the base of the brain, followed by coagulation or moving and padding away any compressing blood vessels. The advantage is pain relief without numbness in the majority of patients, which usually lasts indefinitely. If the pain recurs after a MVD, which it does in 10-15% of patients, it can usually be controlled with low dose Tegretol® or Neurontin®. If the pain continues, it will require a repeat MVD or one of the destructive procedures.

Surgical Options: Destructive Procedures

There are multiple destructive procedures which are beneficial in the treatment of Trigeminal Neuralgia. The most common of which are glycerol injections, gamma knife radiation, electrocoagulation, and balloon compression. These procedures are all based on interrupting the pain by partial damage to Trigeminal nerve fibers. Generally the more numbness they produce, the longer they last. The specific advantages and disadvantages need to be discussed with the surgeon performing the procedure. These procedures are recommended for patients who have failed MVD or are not candidates for major surgery.

Comments

Treatment is always individualized.  All of the options above should be considered in consultation with a neurosurgeon familiar in their use.

Recommendations

Based on the data currently available, and in an effort to maximize quality of life, we recommend the following:

          Patients with less than 10 year life expectancy

Refer for destructive procedure if pain not controlled medically without significant side effects

          Patients with more than 10 but less than 20 year life expectancy

Consider destructive procedure

May abolish need for continued increasing medications

Will make medical therapy easier even if fails

        Patients with more than 20 year life expectancy

Perform thin cut MRI with 3-D Volume Acquisition

If vessel present recommend MVD

Consideration needs to be given to current life expectancy charts at time of implementation. At this time life expectancy is shown below:

Current Age Life Expectancy
50 30 years
55 28 years
60 24 years
65 20 years
70 16 years
75 12 years
80 9 years
85 6 years
90 5 years

(data from IRS Publication 590, Appendix E, Table 1, December 12, 1999)

When a destructive procedure is required, Gamma Knife stereotactic radiosurgery is the procedure of choice because it is least invasive and has the lowest risk of numbness or other side effects, while producing excellent pain relief in most patients with a low incidence of recurrence.

For additional information, please see Trigeminal Neuralgia: Individualized Surgical Management in the 21st Century.

25 ARTICLE SECTIONS From the Mayo Clinic. 
Trigeminal neuralgia                       http://www.mayoclinic.com/health/trigeminal-neuralgia/DS00446

Introduction

Imagine having a jab of lightning-like pain shoot through your face when you brush your teeth or put on makeup. Sound excruciating? If you have trigeminal neuralgia, attacks of such pain are frequent and can often seem unbearable.

You may initially experience short, mild attacks, but trigeminal neuralgia can progress, causing longer, more frequent bouts of searing pain. These painful attacks can be spontaneous, but they may also be provoked by even mild stimulation of your face, including brushing your teeth, shaving or putting on makeup. The pain of trigeminal neuralgia may occur in a fairly small area of your face, or it may spread rapidly over a wider area.

Because of the variety of treatment options available, having trigeminal neuralgia doesn't necessarily mean you're doomed to a life of pain. Doctors usually can effectively manage trigeminal neuralgia, either with medications or surgery.

Signs and symptoms

An attack of trigeminal neuralgia can last from a few seconds to about a minute. Some people have mild, occasional twinges of pain, while other people have frequent, severe, electric-shock-like pain. The condition tends to come and go. You may experience attacks of pain off and on all day, or even for days or weeks at a time. Then, you may experience no pain for a prolonged period of time. Remission is less common the longer you have trigeminal neuralgia.

People who have experienced severe trigeminal neuralgia have described the pain as:

  • Lightning-like or electric-shock-like
  • Shooting
  • Jabbing
  • Like having live wires in your face

Trigeminal neuralgia usually affects just one side of your face. The pain may affect just a portion of one side of your face or spread in a wider pattern. Rarely, trigeminal neuralgia can affect both sides of your face, but not at the same time.

Causes

Illustration showing branches of the trigeminal nerve Branches of the trigeminal nerve CLICK TO ENLARGE

The condition is called trigeminal neuralgia because the painful facial areas are those served by one or more of the three branches of your trigeminal nerve. This large nerve originates deep inside your brain and carries sensation from your face to your brain. The pain of trigeminal neuralgia is due to a disturbance in the function of the trigeminal nerve. Trigeminal neuralgia is also known as tic douloureux.

The cause of the pain usually is due to contact between a normal artery or vein and the trigeminal nerve at the base of your brain. This places pressure on the nerve as it enters your brain and causes the nerve to misfire. Physical nerve damage or stress may be the initial trigger for trigeminal neuralgia.

After the trigeminal nerve leaves your brain and travels through your skull, it divides into three smaller branches, controlling sensation throughout your face:

  • The first branch controls sensation in your eye, upper eyelid and forehead.
  • The second branch controls sensation in your lower eyelid, cheek, nostril, upper lip and upper gum.
  • The third branch controls sensations in your jaw, lower lip, lower gum and some of the muscles you use for chewing.

You may feel pain in the area served by just one branch of the trigeminal nerve, or the pain may affect all branches on one side of your face.

Besides compression from blood vessel contact, other less frequent sources of pain to the trigeminal nerve may include:

  • Compression by a tumor
  • Multiple sclerosis
  • A stroke affecting the lower part of your brain, where the trigeminal nerve enters your central nervous system

A variety of triggers, many subtle, may set off the pain. These triggers may include:

  • Shaving
  • Stroking your face
  • Eating
  • Drinking
  • Brushing your teeth
  • Talking
  • Putting on makeup
  • Encountering a breeze
  • Smiling

Trigeminal neuralgia affects women more often than men. The disorder is more likely to occur in people who are older than 50. About 5 percent of people with trigeminal neuralgia have other family members with the disorder, which suggests a possible genetic cause in some cases.

When to seek medical advice

Some people mistake the pain of trigeminal neuralgia for a toothache or a headache. It's not uncommon for people to believe that their facial pain is dental-related, particularly when the pain seems to stem from the gumline or is located near a tooth.

If you experience facial pain, particularly prolonged pain or pain that hasn't gone away with use of over-the-counter pain relievers, see your dentist or doctor.

Screening and diagnosis

If you go to your dentist, an examination of your mouth can reveal whether a problem with your teeth or gums is causing your pain.

If you go to your doctor, he or she will want to ask about your medical history and have you describe your pain — how severe it is, what part of your face it affects, how long pain lasts and what seems to trigger episodes of pain. You'll also undergo a neurologic examination. During this examination, your doctor examines and touches parts of your face to try to determine exactly where the pain is occurring and — if it appears that you have trigeminal neuralgia — which branches of the trigeminal nerve may be affected.

Your doctor may exclude other possible conditions based on your medical history, the examination, and a magnetic resonance imaging (MRI) scan of your head.

Treatment

Medications are the usual initial treatment for trigeminal neuralgia. Medications are often effective in lessening or blocking the pain signals sent to your brain. A number of drugs are available. If you stop responding to a particular medication or experience too many side effects, switching to another medication may work for you.

Medications

  • Carbamazepine (Tegretol, Carbatrol). Carbamazepine, an anticonvulsant drug, is the most common medication that doctors use to treat trigeminal neuralgia. In the early stages of the disease, carbamazepine controls pain for most people. However, the effectiveness of carbamazepine decreases over time. Side effects include dizziness, confusion, sleepiness and nausea.
  • Baclofen. Baclofen is a muscle relaxant. Its effectiveness may increase when it's used in combination with carbamazepine or phenytoin. Side effects include confusion, nausea and drowsiness.
  • Phenytoin (Dilantin, Phenytek). Phenytoin, another anticonvulsant medication, was the first medication used to treat trigeminal neuralgia. Side effects include gum enlargement, dizziness and drowsiness.
  • Oxcarbazepine (Trileptal). Oxcarbazepine is another anticonvulsant medication and is similar to carbamazepine. Side effects include dizziness and double vision.

Doctors may sometimes prescribe other medications, such as lamotrignine (Lamictal) or gabapentin (Neurontin).

Some people with trigeminal neuralgia eventually stop responding to medications, or they experience unpleasant side effects. For those people, surgery, or a combination of surgery and medications, may be an option.

Surgery
The goal of a number of surgical procedures is to either damage or destroy the part of the trigeminal nerve that's the source of your pain. Because the success of these procedures depends on damaging the nerve, facial numbness of varying degree is a common side effect. These procedures involve:

  • Alcohol injection. Alcohol injections under the skin of your face, where the branches of the trigeminal nerve leave the bones of your face, may offer temporary pain relief by numbing the areas for weeks or months. Because the pain relief isn't permanent, you may need repeated injections or a different procedure.
  • Glycerol injection. This procedure is called percutaneous glycerol rhizotomy (PGR). "Percutaneous" means through the skin. Your doctor inserts a needle through your face and into an opening in the base of your skull. The needle is guided into the trigeminal cistern, a small sac of spinal fluid that surrounds the trigeminal nerve ganglion (the area where the trigeminal nerve divides into three branches) and part of its root. Images are made to confirm that the needle is in the proper location. After confirming the location, your doctor injects a small amount of sterile glycerol. After three or four hours, the glycerol damages the trigeminal nerve and blocks pain signals. Initially, PGR relieves pain in most people. However, some people have a recurrence of pain, and many experience facial numbness or tingling.
  • Balloon compression. In a procedure called percutaneous balloon compression of the trigeminal nerve (PBCTN), your doctor inserts a hollow needle through your face and into an opening in the base of your skull. Then, a thin, flexible tube (catheter) with a balloon on the end is threaded through the needle. The balloon is inflated with enough pressure to damage the nerve and block pain signals. PBCTN successfully controls pain in most people, at least for a while. Most people undergoing PBCTN experience facial numbness of varying degrees, and more than half experience nerve damage resulting in a temporary or permanent weakness of the muscles used to chew.
  • Electric current. A procedure called percutaneous stereotactic radiofrequency thermal rhizotomy (PSRTR) selectively destroys nerve fibers associated with pain. Your doctor threads a needle through your face and into an opening in your skull. Once in place, an electrode is threaded through the needle until it rests against the nerve root.

    An electric current is passed through the tip of the electrode until it's heated to the desired temperature. The heated tip damages the nerve fibers and creates an area of injury (lesion). If your pain isn't eliminated, your doctor may create additional lesions.

    PSRTR successfully controls pain in most people. Facial numbness is a common side effect of this type of treatment. The pain may return after a few years.

  • Microvascular decompression (MVD). A procedure called microvascular decompression (MVD) doesn't damage or destroy part of the trigeminal nerve. Instead, MVD involves relocating or removing blood vessels that are in contact with the trigeminal root and separating the nerve root and blood vessels with a small pad. During MVD, your doctor makes an incision behind one ear. Then, through a small hole in your skull, part of your brain is lifted to expose the trigeminal nerve. If your doctor finds an artery in contact with the nerve root, he or she directs it away from the nerve and places a pad between the nerve and the artery. Doctors usually remove a vein that is found to be compressing the trigeminal nerve.

    MVD can successfully eliminate or reduce pain most of the time, but as with all other surgical procedures for trigeminal neuralgia, pain can recur in some people. While MVD has a high success rate, it also carries risks. There are small chances of decreased hearing, facial weakness, facial numbness, double vision, and even a stroke or death. The risk of facial numbness is less with MVD than with procedures that involve damaging the trigeminal nerve.

  • Severing the nerve. A procedure called partial sensory rhizotomy (PSR) involves cutting part of the trigeminal nerve at the base of your brain. Through an incision behind your ear, your doctor makes a quarter-sized hole in your skull to access the nerve. This procedure usually is helpful, but almost always causes facial numbness. And it's possible for pain to recur. If your doctor doesn't find an artery or vein in contact with the trigeminal nerve, he or she won't be able to perform an MVD, and a PSR may be done instead.
  • Radiation. Gamma-knife radiosurgery (GKR) involves delivering a focused, high dose of radiation to the root of the trigeminal nerve. The radiation damages the trigeminal nerve and reduces or eliminates the pain. Relief isn't immediate and can take several weeks to begin. GKR is successful in eliminating pain more than half of the time. Sometimes the pain may recur. The procedure is painless and typically is done without anesthesia. Because this procedure is relatively new, the long-term risks of this type of radiation are not yet known.

  • Coping skills

    Living with trigeminal neuralgia can be difficult. The disorder may affect your interaction with friends and family, your productivity at work, and the overall quality of your life.

    You may find that talking to a counselor or therapist can help you cope with the effects of trigeminal neuralgia, or you may find encouragement and understanding in a support group. Although support groups aren't for everyone, they can be good sources of information. Group members often know about the latest treatments and tend to share their own experiences. If you're interested, your doctor may be able to recommend a group in your area.
27 Background: Trigeminal neuralgia (TN), also known as tic douloureux, is a pain syndrome recognizable by patient history alone. The condition is characterized by pain often accompanied by a brief facial spasm or tic. Pain distribution is unilateral and follows the sensory distribution of cranial nerve V, typically radiating to the maxillary (V2) or mandibular (V3) area. At times, both distributions are affected. Physical examination eliminates alternative diagnoses. Signs of cranial nerve dysfunction or other neurologic abnormality exclude the diagnosis of idiopathic TN and suggest that pain may be secondary to a structural lesion.

Pathophysiology: The mechanism of pain production remains controversial. One theory suggests that peripheral injury or disease of the trigeminal nerve increases afferent firing in the nerve; failure of central inhibitory mechanisms may be involved as well. Pain is perceived when nociceptive neurons in a trigeminal nucleus involve thalamic relay neurons.

Aneurysms, tumors, chronic meningeal inflammation, or other lesions may irritate trigeminal nerve roots along the pons. An abnormal vascular course of the superior cerebellar artery is often cited as the cause. In most cases, no lesion is identified, and the etiology is labeled idiopathic by default. Uncommonly, an area of demyelination from multiple sclerosis may be the precipitant. Lesions of the entry zone of the trigeminal roots within the pons may cause a similar pain syndrome. Thus, although TN typically is caused by a dysfunction in the peripheral nervous system (the roots or trigeminal nerve itself), a lesion within the central nervous system may rarely cause similar problems.

Infrequently, adjacent dental fillings composed of dissimilar metals may trigger attacks.

Frequency:
 

  • Internationally: TN is uncommon, with an estimated prevalence of 155 cases per million persons.

Mortality/Morbidity:

  • No mortality is associated with idiopathic TN, although secondary depression is common if a chronic pain syndrome evolves. In rare cases, pain may be so frequent that oral nutrition is impaired.
  • In symptomatic or secondary TN, morbidity or mortality relates to the underlying cause of the pain syndrome.

Sex: Male-to-female ratio is 2:3.

Age: Development of trigeminal neuralgia in a young person suggests the possibility of multiple sclerosis.

  • Idiopathic TN typically occurs in patients in the sixth decade of life, but it may occur at any age.
  • Symptomatic or secondary TN tends to occur in younger patients.

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