Could Trigeminal neuralgia be a symptom

[Alanac]

Ive been getting a really sharp 'electric shock' like pain in my face. I seem to get it on the right most of the time around the forehead and cheek and the attacks of pain seem to be becoming more frequent. Ive been getting the pain for about 8 months but its never really bothered me at all until about 3 weeks ago when everything seemed to trigger the pain. Most of the time the attacks of pain are triggered when I get hot or enter a hot enviroment and through direct exposure to the sun. It's also triggered if something makes me jump, catches me off guard and sometimes it just occurs for no reason. When I get the pain its sometimes seems to shoot down my back and along the front of my chest as well if it's really bad. Ive been told by my doctor its probably Trigeminal neuralgia but im only 17 and Ive seen a lot of info on it all saying that onset of TN in young adult suggests MS, How comon is it for TN to be a first symptom of MS in young people?

[Garth L Nicolson, PhD]

Although TN is certainly more common in people over 50, it has been documented in patients as young as 3 years-old.

Several theories exist to explain the possible causes of TN. It was once believed that the nerve was compressed in the opening from the inside to the outside of the skull; but newer research indicates that it can be an enlarged blood vessel - possibly the superior cerebellar artery - compressing or throbbing against the microvasculature of the trigeminal nerve near its connection with the pons. Such a compression can injure the nerve's protective myelin sheath and cause erratic and hyperactive functioning of the nerve. This can lead to pain attacks at the slightest stimulation of any area served by the nerve as well as hinder the nerve's ability to shut off the pain signals after the stimulation ends. This type of injury may rarely be caused by an aneurysm (an outpouching of a blood vessel); by a tumor; by an arachnoid cyst in the cerebellopontine angle; or by a traumatic event such as a car accident or even a tongue piercing.  It can also be caused by a chronic infection, and this latter explanation is one that is slowly gaining some traction among professionals who work on this problem.  

A large portion of MS patients have TN, but not everyone with TN has MS. Only 2-4% of patients with TN, have MS, and these are usually younger patients.  

In our studies on MS, a large proportion have chronic bacterial and viral infections (I just published a large two-part review on this in the British Journal of Medical Practitioners, Dec. 2009 and March 2010).  If you are interested, you can download free copies from their website, www.bjmp.org

Could one of the above possible causes be involved in your situation?  At this point, this question cannot be answered, but it does give you some avenues for exploration.

[Garth L Nicolson, PhD]

To begin with there is a short of the most likely infections on our website, www.immed.org, under the Clinical Testing heading.  This is not an exhaustive list, only an abbreviated list of what we consider the most likely infections that seem to cause many chronic pain and other problems.  

As to how you "got it", no one can adequately explain how a person contracts a particular infection, but some of the more likely means are: airborne, direct contact, fluid exchange, placental or birth canal, and accidental contamination during a medical procedure.

[painterchic]

Thank you for your informative and interesting post. I reposted it in the TN forum also for others to read and learn. It raises some interesting questions. I read the 2009 article in the BJMP and found it very intriguing on many levels. I am currently in the process of not only validating a diagnosis of TN, but trying to understand WHY or HOW I got it. I have been told that the only way to be certain is to do the MVD surgery and even that is not foolproof if it turns out not to be a blood vessel. Your research on infections is interesting because of course most of us have infections at some point or another, but I recently was diagnosed with shingles before the TN, and am still trying to verify that as it complicates my treatment plan. Also other infections and symptoms you listed make me curious, but with so many overlapping symptoms, sometimes spanning a long period of time, how does one even go about testing for anything? I would love to hear your thoughts on this and will gladly provide you more details in a PM if you like.
Thank you,
JB

[Garth L Nicolson, PhD]

I believe that my earlier response should cover these problems, which can occur together with TN but may or may not be directly related.

[Alanac]

Also forgot to mention that there have been other symptoms other than trigeminal neuralgia. For about 2 years now ive been very sensitive to the cold. My hands seem cold all the time even on warm days and often turn blue when I walk to school in the mornings. As well as this ive recently been getting an increased sensitivity to heat, which is one of the main triggers of the attacks of pain of the TN. I always feel tired even after a good nights sleep and struggle to keep my eyes open during lessons. I cant even do my tap dancing properly anymore because I either get too hot which triggers the TN pain or my feet become too heavy to actually be able to dance.

[Alanac]

There is no obvious cause as i've not been in any accidents etc. my great aunt has multiple sclerosis and my mum suffered from acute disseminated encephalomyelitis last year but I dont know if that would have anything to do with it.