FAQ - Neuralgia
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What is the difference between neuritis and neuralgia ?


Neuritis is the inflammation of a nerve

Neuralgia (as trigeminal) cause not completely understood but can be from a blood vessel or a tumour pressing on the nerve root.

Postherpetic(shingles) neuralgia caused by damage to the nerve.  (+ info)

Does anyone have any info on Trigeminal Neuralgia?


I was just diagnosed with it last week and have been taking tegretol (sp?). It seems to be helping but wears off very quickly. My dr only prescribed 200mg per day to see if it would work. I have been suffering from debilitating pain for 2 yrs. This medicine is the only thing that has helped. Would be interested to hear what dosage/medicines others are taking.
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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.

Comprehensive treatment options available. Dedicated neurologists and neurosurgeons have years of experience treating this condition.

Basically, three kinds of treatment are available:

Medication
Surgery
Combination of medication and surgery
Medication
Medications used to treat trigeminal neuralgia include:

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.

Trigeminal neuralgia often follows a "remitting and relapsing course" in which some patients experience pain, have their pain controlled with medication, and then, after weeks or months, are weaned off the medication and remain pain-free.

While some who have trigeminal neuralgia receive adequate pain control with medications only, others eventually stop responding to their medications or they experience side effects. For those people, surgery — or a combination of surgery and medications — may be an option.

The goal of a number of surgical procedures is to either damage or destroy the part of the trigeminal nerve that is the source of the pain. Because the success of these procedures depends on damaging the nerve, one side effect is facial numbness of varying degrees.

These procedures include:

Alcohol injection
Alcohol injections under the skin around the branches of the trigeminal nerve may offer temporary relief by numbing the areas for days or months. Because the pain relief is not always permanent, repeated injections may be needed.

Glycerol injection
This procedure is called percutaneous glycerol rhizotomy (PGR); percutaneous means through the skin. A needle is inserted into the trigeminal nerve at the base of the skull where the trigeminal nerve root exits the skull. X-rays are taken to confirm that the needle is in the proper location. Once the location is confirmed, a small amount of sterile glycerol is injected. After three or four hours, the glycerol damages the trigeminal nerve and blocks pain signals.

Initially, PGR relieves pain in most people. However, pain recurs in many people, and many experience mild facial numbness or tingling.

Balloon compression
In percutaneous balloon compression of the trigeminal nerve (PBCTN), a needle is inserted through the face and into the hole at the base of the skull where the trigeminal nerve exits. 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 compress the nerve, thereby blocking the pain signals.

PBCTN successfully controls pain in most people. Most people undergoing PBCTN experience facial numbness of varying degrees, and some patients experience weakness in the muscles used for chewing that is often temporary.

Electric current
Percutaneous stereotactic radiofrequency thermal rhizotomy (PSR) selectively destroys nerve fibers associated with pain. A needle is inserted through the face and into the opening in the skull for the trigeminal nerve. Once the needle is in place, an electrode is threaded through the needle until it rests against the nerve root.

The electrode's position is verified by electrically stimulating the trigeminal nerve. Then a current is passed through the tip of the electrode until it is heated to the desired temperature for about 70 seconds. This damages the nerve fibers and creates an area of injury (lesion). If the pain is not eliminated, additional lesions may be created.

PSR successfully controls pain in most people. A common side effect of this treatment is mild to severe facial numbness. As with the other percutaneous procedures, the pain may recur after months or years, and repeat procedures may be necessary.

Stereotactic radiosurgery
Stereotactic radiosurgery involves delivering single doses of radiation to the root of the trigeminal nerve. The radiation damages the trigeminal nerve and eliminates the pain. Stereotactic radiosurgery is successful in eliminating pain more than half of the time. The procedure is painless and typically is done without anesthesia. It may take between three weeks and three months for pain relief to begin. Read more about stereotactic radiosurgery.

Microvascular decompression (MVD)
A procedure called microvascular decompression (MVD) involves relocating or removing blood vessels that have contact with the trigeminal nerve root where it leaves the brain stem. MVD does not damage or destroy part of the trigeminal nerve.

Microvascular decompression is a major surgical procedure done under general anesthesia in the operating room. Commonly, two to three days in the hospital are required after surgery. A small incision is made behind the ear. Then, through a small opening made in the skull, the trigeminal nerve is directly inspected with the aid of a microscope. If the surgeon sees an artery in contact with the nerve root, he or she directs it away from the nerve and places a small Teflon pad between the nerve and the artery to prevent contact with the nerve.

The majority of patients who have this procedure performed by a qualified neurosurgeon have no facial numbness and are pain-free, requiring no further medications. Usually, the pain relief is instant.

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.

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 pa  (+ info)

how can someone find pleasure with trigeminal neuralgia?


The pain involved in this disorder in very unbelievable, why does it get in the way of finding a girlfriend to lessen the pain?
Well having a girlfriend would not lessen the pain
but it would make life more bearable, and not looking for one on-line neither.
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It sounds like you need to take care of yourself first before getting someone else to be with you to lessen the pain. Try meditation, this may help you to see past the pain and give yourself a break. There are videos you can get that may help. Also getting a massage will be helpfull (though not on the affected areas or trigger zone)(By an RMT) Consider seeing a naturopath, exaust all ways in which to give yourself some relief. Good luckl.  (+ info)

Anyone tell me what the symptoms are for neuralgia?


I have had a pain in my right cheek which extends to the right temple for months and have been to both the dentist and the doctor (who thought it may be arthritis) and to date have had little help from either. It was suggested to me by someone that it may be neuralgia. Can anyone advise
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I was advised that I had neuralgia, I had been to the dentist, he found nothing wrong, so I lived with the pain for two years, it turned out to be an abscess,when the dentist drilled the tooth to allow the abscess to drain he had to take several steps back as the smell was horrible. Just go back to the dentist and ask if there could be a problem that he has not been able to detect! If it is neuralgia you would need to visit the doctor again and ask his advise.PUT THE WORD IN RESERCH YOUR ANSWER.  (+ info)

Does any one out there have trigeminal Neuralgia?


I'm going to the doctor Monday to see if that is my problem. Face hurts alot.
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YES!
and there is help for you! I have had a series of shots of lidocaine, and now we are going to Nerve Blocks...

The lidocaine helped alot, but didnt last as long as he tells me the blocks will..so I am looking forward to relief..and thankfully YOU CAN TOO...


THERE ARE SEVERAL USEFUL MEDS.. klonopin (kinda like valium, but I will NOT take valium)
Others like trileptal and neurontin..


If you need a contact and want to message I would love to..
I do know hun there is relief in sight...so Hang in there!  (+ info)

Pain relief for trigenimal neuralgia so I can sleep?


I haven't had this long and am taking Tegretol TID (three times daily). My jaw is still killing me. What else can I do?
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  (+ info)

Is Temporomandibular Joint Disorder and Trigerminal Neuralgia related in any way?


They are two separate concerns BUT are quite frequently found together in the patient for many reasons. Many of those with one or both of these are grinders and the damage can result in effect on the joint and the nerve. The TG nerve also lines through the joint area and nerve damage in this area can "feel" shared. TN is very difficult to diagnose and many go for years without relief - TMJ is normally found by the dentist or confirmed this way - symptoms are very distinct where as with TN they have variables and the atypical. TMJ can be mild to severe even locking in the joint.
I suffer from atypical trigerminal neuralgia - was blessed that it only went on for 5 to 6 months before a proper diagnosis was made. I went to the dentist and endodontist more than you can imagine - atypical means that mine can linger for hours and not just quick stabs over a period of time. Both are horrid. Meds can help to regulate the events and there are often times of reprieve when the nerve just calms down for a while (weeks to years) but it tends to never go away. Most common in females 50 and over. I also have mild TMJ and yes - MD concurs that they are often found in the same patient - but you can have TMJ and not TN - Most TN blogs mention TMJ as a side effect.
Clear as Mud - right? I hope you suffer from neither.  (+ info)

How do you get relief from trigeminal neuralgia pain?


I suffered from TN for 4 years and some 15 doctors before it was properly diagnosed by a neurosurgeon. No meds worked for me, it was CONSTANT SEVERE PAIN. I had the surgery developed by Dr. Peter Jannetta, and it was the best thing to do. 100% pain-free instantly! That was 2 years ago and I'm still thankful every day for having the surgery.

Contact his office to find a neurosurgeon he has trained that practices in your area.

Contact me if you want more info.  (+ info)

What is the relationship between herpes, trigeminal neuralgia and fibromyalgia?


herpes is a virus that lives dormant in the nerves, trigeminal neuralgia is a shooting nerve pain- kind of like electricity running down a nerve, and fibromyalgia are pretty much muscle pains.  (+ info)

Has anyone ever had experience with Trigeminal Neuralgia?


My father has been diagnosed with this and is thinking about having surgery done to take care of it, but we have been researching and hoping to get input that doesnt involve surgery.
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I have trigeminal neuralgia. If your dad doesn't have the book "Striking Back", he needs to get a copy ASAP. It is a very complete resource for a very rare affliction. I am on Trileptal, and that keeps it under control. I also had surgery (microvascular decompression), and got some relief from that. All the options for treatment are in the book. Good luck you you and your dad!  (+ info)

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