Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Neurology (Expert Forum)
Re: Trigeminal Neuralgia
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.
Re: Trigeminal Neuralgia
by cf-neuro-MD, Jan 01, 1995 12:00AM
Posted By ccf neuro M.D.* on November 15, 1997 at 00:17:39:
In Reply to: Trigeminal Neuralgia posted by Alan Bissell on October 28, 1997 at 16:34:45:
To whomever answers questions:
I am 2.5 years post rotor rooter sinus surgery. The left side was full and had to be scraped. Disgusting was my surgeons word. All went well for 1 year when a head cold/virus hit. Within two days of my head clearing and drying up I started to experience symptoms which have been confirmed as Trigeminal Neuralgia in all three branches. It has been controlled with Tegretol for the last year. Two weeks ago I had a head cold/virus and within one day of my head drying up I blew right up through the medications to full blown big ones. It skipped right over the smaller shocks.
My questions:
1 Is it possible this is mere coincidence?
2 If this is nerve damage what is going on during the drying up stage that is trashing me and what can be done about it?
3 Could this be a virus based problem and what could I do about it?
Thank you for any information you may be able to share.
Alan Bissell
--------------------------------------------------------------------------------------------------------------------
Alan,
Your question is an interesting one. Most cases of trigeminal neuralgia are caused by a small blood vessel pressing against the fifth cranial (=trigeminal) nerve. A significant minority of cases, however, are caused by multiple sclerosis. For this reason, many neurologists will perform an MRI scan of a patient's brain with contrast (gadolinium) when the condition is first diagnosed or follows an unusual course, to exclude the possibility of multiple sclerosis, brain tumors, or rarely inflammation or other problem in an area known as Meckel's cave near the base of the brain, where the pain sensing nerve fiber cell bodies are all concentrated together in one spot. Multiple sclerosis attacks and other immunologically sensitive conditions are often triggered by infections, viral or otherwise. It has been recently discovered that most cases of Bell's palsy, which is attacks of facial paralysis secondary to inflammation of the SEVENTH cranial nerve, are caused by herpes virus (cold sore virus, not the sexually transmitted form of herpes virus) infections of the nerve. Thus it is at the very least theoretically that viral infection of the trigeminal nerve might be a rare cause of trigeminal neuralgia. One would also expect symptoms associated with the motor branch of the nerve as well, however, if this were indeed the case. Specifically, you would also have trouble chewing on the side of the pain, and would notice your jaw pushing toward the side of the pain when you opened your mouth or were eating. If your symptoms do not settle down and if you already know that there is not a tumor or other "surprise" underlying cause of your trigeminal neuralgia, other treatment options include Dilantin, another drug similar to Tegretol, and baclofen. Surgical options for resistant cases include injection of glycerol into the nerve, or damaging the nerve with a radiofrequency device that destroys the pain generating nerve fibers--- but at the expense of leaving you with permanent numbness in each of the treated divisions of the nerve. This can be a big problem for the uppermost or first division of the nerve, which supplies sensation to the eye, and can result in corneal abrasions and ulcers due to an inability to feel dust and dirt in the affected eye. The ultimate "fix" for the problem is brain surgery to physically place a sponge between the blood vessel and the part of the nerve it is pressing against. There are of course risks associated with such surgery, but it is a relatively safe and effective undertaking as far as brain surgeries go. At any rate, I would suggest seeing your treating neurologist soon to be sure s/he does not think additional evaluation is warranted given the sudden increase in the severity of your symptoms. As you well know, the pain of this condition is second to none!!!! Good Luck.
If you are near the Cleveland area and are interested in a second opinion for your case, we would of course be happy to provide you with one. The department of neurology's number is 1-800-223-2273 extension 45559. Any of our staff neurologists could evaluate this particular problem.
Please remember that information provided on the forum is intended for general medical informational purposes and that the actual diagnosis and treatment of your particular medical condition should be strictly in conjunction with your treating physician(s). We hope you find the information provided useful.
In Reply to: Trigeminal Neuralgia posted by Alan Bissell on October 28, 1997 at 16:34:45:
To whomever answers questions:
I am 2.5 years post rotor rooter sinus surgery. The left side was full and had to be scraped. Disgusting was my surgeons word. All went well for 1 year when a head cold/virus hit. Within two days of my head clearing and drying up I started to experience symptoms which have been confirmed as Trigeminal Neuralgia in all three branches. It has been controlled with Tegretol for the last year. Two weeks ago I had a head cold/virus and within one day of my head drying up I blew right up through the medications to full blown big ones. It skipped right over the smaller shocks.
My questions:
1 Is it possible this is mere coincidence?
2 If this is nerve damage what is going on during the drying up stage that is trashing me and what can be done about it?
3 Could this be a virus based problem and what could I do about it?
Thank you for any information you may be able to share.
Alan Bissell
--------------------------------------------------------------------------------------------------------------------
Alan,
Your question is an interesting one. Most cases of trigeminal neuralgia are caused by a small blood vessel pressing against the fifth cranial (=trigeminal) nerve. A significant minority of cases, however, are caused by multiple sclerosis. For this reason, many neurologists will perform an MRI scan of a patient's brain with contrast (gadolinium) when the condition is first diagnosed or follows an unusual course, to exclude the possibility of multiple sclerosis, brain tumors, or rarely inflammation or other problem in an area known as Meckel's cave near the base of the brain, where the pain sensing nerve fiber cell bodies are all concentrated together in one spot. Multiple sclerosis attacks and other immunologically sensitive conditions are often triggered by infections, viral or otherwise. It has been recently discovered that most cases of Bell's palsy, which is attacks of facial paralysis secondary to inflammation of the SEVENTH cranial nerve, are caused by herpes virus (cold sore virus, not the sexually transmitted form of herpes virus) infections of the nerve. Thus it is at the very least theoretically that viral infection of the trigeminal nerve might be a rare cause of trigeminal neuralgia. One would also expect symptoms associated with the motor branch of the nerve as well, however, if this were indeed the case. Specifically, you would also have trouble chewing on the side of the pain, and would notice your jaw pushing toward the side of the pain when you opened your mouth or were eating. If your symptoms do not settle down and if you already know that there is not a tumor or other "surprise" underlying cause of your trigeminal neuralgia, other treatment options include Dilantin, another drug similar to Tegretol, and baclofen. Surgical options for resistant cases include injection of glycerol into the nerve, or damaging the nerve with a radiofrequency device that destroys the pain generating nerve fibers--- but at the expense of leaving you with permanent numbness in each of the treated divisions of the nerve. This can be a big problem for the uppermost or first division of the nerve, which supplies sensation to the eye, and can result in corneal abrasions and ulcers due to an inability to feel dust and dirt in the affected eye. The ultimate "fix" for the problem is brain surgery to physically place a sponge between the blood vessel and the part of the nerve it is pressing against. There are of course risks associated with such surgery, but it is a relatively safe and effective undertaking as far as brain surgeries go. At any rate, I would suggest seeing your treating neurologist soon to be sure s/he does not think additional evaluation is warranted given the sudden increase in the severity of your symptoms. As you well know, the pain of this condition is second to none!!!! Good Luck.
If you are near the Cleveland area and are interested in a second opinion for your case, we would of course be happy to provide you with one. The department of neurology's number is 1-800-223-2273 extension 45559. Any of our staff neurologists could evaluate this particular problem.
Please remember that information provided on the forum is intended for general medical informational purposes and that the actual diagnosis and treatment of your particular medical condition should be strictly in conjunction with your treating physician(s). We hope you find the information provided useful.
Member Comments
by vstankosky, Jun 18, 2009 04:03PM
A related discussion, Viral related Trigeminal Neuralgia was started.
by jerasson, Oct 31, 2009 12:09AM
A related discussion, Trieminal Nerve and Ear Infection was started.
