Trigeminal neuralgia
Discussion
I am not a neurologist but I'll throw my knowledge in. TGN is a neurological condition where a sensory nerve in the face becomes hypersensitive and triggers a cascade of pain signals in the brain. It is related to epilepsy, where motor (muscle) nerves trigger muscular spasms in the shape of a 'fit' and this is why the same medications are used to treat both.
Diagnosis may be a process of elimination as the symptoms often start as severe but vaguely located pain, often describe as 'stabbing' or 'red hot needle' pain which radiates to the entire side of the face. Patients sometimes have several dental extractions before diagnosis as the pattern and severity can appear to be like very acute toothache.
The pain is often triggered at a specific point, and patients report triggers on face-washing or shaving.
Pain relief on the prescription af an anti-epileptic such as carbamazepine is diagnostic (i.e. if the pain goes away then it is TGN). Often patients are started on a low dose and gradually increased until symptoms resolve. Side-effects of these drugs are significant. Some cases respond well, others do not (much like epilepsy).
In serious cases, surgery is possible, but high risk.
Diagnosis may be a process of elimination as the symptoms often start as severe but vaguely located pain, often describe as 'stabbing' or 'red hot needle' pain which radiates to the entire side of the face. Patients sometimes have several dental extractions before diagnosis as the pattern and severity can appear to be like very acute toothache.
The pain is often triggered at a specific point, and patients report triggers on face-washing or shaving.
Pain relief on the prescription af an anti-epileptic such as carbamazepine is diagnostic (i.e. if the pain goes away then it is TGN). Often patients are started on a low dose and gradually increased until symptoms resolve. Side-effects of these drugs are significant. Some cases respond well, others do not (much like epilepsy).
In serious cases, surgery is possible, but high risk.
I have been prescribed carbamazepine today, for 4 weeks.
I don't think the doctors are 100% sure what is causing the pain that I'm getting, but the symptoms are very similar to TN.
There is no pattern to my attacks and a varied range of things can trigger one.
I have tried a low dose of Amitriptyline, but it didn't agree with me.
I just want it sorted as the pain is almost as bad as childbirth!
I don't think the doctors are 100% sure what is causing the pain that I'm getting, but the symptoms are very similar to TN.
There is no pattern to my attacks and a varied range of things can trigger one.
I have tried a low dose of Amitriptyline, but it didn't agree with me.
I just want it sorted as the pain is almost as bad as childbirth!
How old are you? Usually affects older people but I had what they told me was TN in my mid 30s - I didn't get the sharp immediate pain I had constant aching pain in my face that I could only describe as 'dragging' that got worse as the day went on. Nobody really knew what caused it (they still don't as far as I know).
Like all nerve pain I found the best way (not easy!) was to relax. Muscle relaxants proved the only help.
Eventually it just disappeared (hopefully never to return!). By the way I'm 61 (Sunday!) now.
I have suffered nerve pain in lots of other areas, such as sciatica from disc ruptures and again here, relaxing/rest/exercise is the main help.
Probably all to do with the immune system.
My late grandfather suffered terribly with TN (they called it tic douloureux) and I vividly recall him going down on his hands and knees holding his face in agony when he had an attack. I never had it to that extent.
Frightening illness.
Like all nerve pain I found the best way (not easy!) was to relax. Muscle relaxants proved the only help.
Eventually it just disappeared (hopefully never to return!). By the way I'm 61 (Sunday!) now.
I have suffered nerve pain in lots of other areas, such as sciatica from disc ruptures and again here, relaxing/rest/exercise is the main help.
Probably all to do with the immune system.
My late grandfather suffered terribly with TN (they called it tic douloureux) and I vividly recall him going down on his hands and knees holding his face in agony when he had an attack. I never had it to that extent.
Frightening illness.
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