Attack of trigeminal neuralgia OMG

[essdipity]

For several days now I've had excruciating facial pain. It's all on the right side, and covers the lower cheek bone across to the ear, upper and lower teeth, and lower jaw and gums. Not all the time, and not all these places at once. There can be horrible pain in one tooth, as if a dentist hit the nerve, or it can move down the gum, etc. These are the acute parts, and can last for several  minutes. Sometimes the pain subsides to a very bad and long-lastimg ache, but that's much more manageable than the other.Then it goes away altogether, until....

I don't have a sinus or ear infection, I don't have TMJ disorder, and a few weeks ago I had a dentist appt when x-rays were done. My teeth are fine. I told all this to my neuro, and he agreed it's TN. He faxed a script for Tegretol, but the pharmacy had to order it and it won't be ready till noon today.

There have been many discussions about this over the years on the forum, though I don't remember any recently. Have I missed something? Any current posters have TN? It definitely can be caused by MS. I'm starting to wonder whether Tecfidera is effective for me. Been on it about 10 months. A month or so ago my long-term burning paresthesias spread and got worse, which may or may not be significant, but now this, the most agonizing pain imaginable.

My Tegretol prescription is for 200mg twice a day. Is this a low dose? I usually need megadoses of everything :-(

ess

[bbassel]

Omg you poor thing! I can't imagine the paiin you muuust be in! I am thinking of uyou and wishing it will be over soon! Big hugs
Barb

[supermum_ms]

There's nothing that can fix it, it's not a grinding teeth/ jaw clenching thing for me, it's actually another genetic hiccup passed down through my dad. My younger brother, my youngest and I all have 'some' hypermobile joints, Joint hypermobility syndrome which is more commonly known as being double jointed.

We're all different mind you, It's very mild in our family, basically unless a joint pops out of it's socket it's never actually caused any of us any major problems. My brother has the overly pronounced flex in his elbows, son's is shoulder blades, elbows and fingers, and mine is jaw, wrists, fingers/thumbs. I've always been flexible without trying and i've assumed i'm still as flexible as i am in part because of the hypermobility and all the years of ballet and gymnastics training I did throughout my childhood.

One bad fall not that long ago, my body ached in places i didn't know i had but I didn't realise my jaw was out of alignment again until going on two weeks later, lol only worked it out after i face planted whilst wakeboarding, I hit the water so hard I lost all vision for a few minutes but it was an instant cure for my jaw ache though and so worth it :D

TN is a different devil, it stops you in your tracks it's so painful i think you only start breathing again when it just as suddenly stops, it always happen's for a few minutes at a time and you can't know how long until the next lightning strike is going to hit you for six. I have actually unhinged my jaw when it's hit, that has  triggered the TMJ more than once but i definitely know which type of pain i'd rather be dealing with out of the two.

Again hugs, it's a beast and a half and i truly hope you get some relief soon!

Thinking of you.........JJ

[HVAC]

It is going to take some time for the Tegretol to work. I have never had TN but have been on Tegretol. I hope it works. If it does not do not hesitate to ask for something else. I am sorry.

Alex

[essdipity]

More thanks for comments and suggestions. I've done some reading myself, to learn about the different types of TN. It seems a lot of what I have is the second, mixed with either the first or a very extreme version of the second. Apparently variations like this are possible.

Right now, at 5 am, a lower right molar aches very badly, and I can see why people go the dental route, since it does seem like a tooth problem. But the pain is not the full throttle kind I also get, the kind that brings me to my knees. I would hardly call that mild.

JJ, it does sound as if you have both TMJ problems and TN. Since the TMJ stuff is usually caused by grinding teeth/clenching jaw at night, maybe your dentist could make you a mouth guard to use overnight. It's a thought, anyway.

Meanwhile my Tegretol seems to be doing zilch.

ess

[supermum_ms]

I'm so sorry your experiencing TN.......HUGS!

I've been told I have TN and or TMJ by different types of doctors and dentists over the years, lots of disagreements and changing of which but i've also been told that i actually have the typical pattern of both.

The TMJ goes way back to a childhood surgery and jaw misalignment, every surgery, throat check ups, dental visit etc. My TMJ symptoms are classic,   basically anything that opens the jaw wide is a trigger, my jaw opening is smaller than it should be, bite is off, jaw pops out of alignment, jaw continually aches from the hinge, jaw movement is stiffer etc

The TN was never pinned down to a known origin, just another of my idiopathic dx collection, TN from my experience is definitely different to TMJ! TN pain is incompatible, sharp lightning strikes, each hit doesn't last long but it does come in wave after wave of indescribable nerve pain, which stops when the hell it chooses too.

The left side of my face has the TN (mandibular V3) nerve pain, but weirdly it's the right side of my face that has the odd patches of paresthesia which I hadn't realised actually runs along the maxillary (V2) nerve    

Cold wind is one of my TN triggers but the first time it was triggered by air travel was an unexpected shocker, it's still vividly in my mind being stuck between two people on a 6+ hour flight and in so much pain i wanted to rip my face off. I've never had a good time with pain meds, can't even remember what i've had prescribed over the years. I do recall the first TN one i tried did help the pain 'a lot' but the side effects always makes things worse, the pain knocks me out which truthfully i'd rather when all is said and done...

TN Information:

This is a really good book on TN and it goes through differentials, meds, myths etc and well worth looking at...

https://books.google.com.au/books?id=vAbU8rfb-OoC&pg=PA82&lpg=PA82&dq=distinguish+TN+from+TMJ&source=bl&ots=lI0RXl2iGz&sig=QMd0DkmDIUHaCuBBpXML3b8YzCo&hl=en&sa=X&ei=NmCLVaG-Kua5mwWkiJaACg&ved=0CDEQ6AEwAzgK#v=onepage&q=distinguish%20TN%20from%20TMJ&f=false

This is a really good teaching site with other very good anatomy articles, sometimes technical but easy to follow..

http://teachmeanatomy.info/head/cranial-nerves/trigeminal-nerve/

This page lists the TN types, basic info, images but it has other links on the site that are worth looking at...

http://www.umanitoba.ca/cranial_nerves/trigeminal_neuralgia/manuscript/types.html
[oops i have others but can't get them up to get the links for you, sorry]

Hope it helps you a little bit

HUGS.........JJ

[Sailorsong]

From what you described it sounds like a mild bout of TN to me, at least from my experience. I've had it twice and each time the entire left side of my face from cheek bone to lower jaw and every tooth (upper and lower) including the missing teeth hurt at a 10 out of 10 level all at the same time with no let up for a week. So maybe your med is working?

  The only way I survived the TN was that I took some hydrocodone even though it really didn't touch the pain it did knock me out for 6 hours at a time. I slept 24/7 for the week except to eat and bathroom visits. I have heard someone say TN is also known as the suicide symptom and from my experience I would believe it.