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Trigeminal Neuralgia

ELT
For those of you with trigeminal neuralgia, would you mind me asking you what it feels like?  I have been assuming, for a while, that what I have in my face is bilateral trigeminal neurlagia.  But, perhaps I'm wrong.  

For me, my gums feel infected, my teeth all think they need root canals, my jaws feel like they are being shoved in, in the hinges, and stabbed, and punched til they are broken, my tongue tip and lips feel like they have shingles, and my face around my mouth, including my nose and cheekbones and jaw, upper and lower, feel numb / burning / itching / tingling.  

I've had it before, it lasts a few weeks to a couple months.  It seems to be creeping up on me really slowly this time.  Been coming on a long while, and I'm usually alright in the morning.  It hurts and stuff, but, not like in the later afternoon, like now, and evening.  Putting ice packs on it helps.  

My scalp is really itchy along with my face, and reaction time to my scratching is delayed.  I avoid scratching 'cause it doesn't really do any good.  But, then I have to.  So, I do.  But, I don't feel it properly, so, a really good scratch feels good.  'Til a few minutes later.  Then, WHAM!!  Pain.  Takes a bit to subside, too.  

It is equal on both sides.  No difference at all.  'Cept maybe the scalp itching.  It seems to hit certain areas more than others.

So, anybody else?  Just curious, I'd like to know if I'm diagnosing myself right.  LOL  I should mention, I took this pain explanation to my neuro, before I had a computer, and I had no idea what it was.  It happened first about three years ago, when I tried keppra, an anti seizure med.  My gp thought it might be an allergic reaction so he took me off it.  I went back to  neuro, and he gave me something else.  It happened still, so he gave me gabapentin.  For my seizures AND the pain.  It helped.

I took it a while, but, didn't like side efffects, tho I've no idea what they were now, lol.  I have lyrica I can take if i need to again, but I don't want to start it before my ep.  And I can live through it again, I'm sure.  It subsides enough that I can live through the misery, LOL.  I think.  LOL.  

My seizures mysteriously disappeared, so I don't need the epilepsy stuff, either, luckily.  

In other words, it wasn't an allergic reaction, I didn't read the symptom and take it to the dod, he's treated me for it with first, gabapentin, then lyrica, without telling me what I had?

So, am I silly in thinking trigeminal neuralgia?

K, I'll shut up now, LOL  :)

Erica
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Avatar universal
Erica, cut one end of an extension cord, plug it in and put it on the side of your face, just kidding dont do it. Ive been living with TN for 17 years.
Helpful - 0
Avatar universal
I've had TN now for 46 years.  At age 9 I was the youngest to have it, but now there are babies with it (so sad). Docs tried lots of things, and every drug. By the time I was 16 they created Tegritol  (carbomezapine) . By the time I was 21 they had perfected decompression surgery, which didn't work.  That being the ultimate solution, and not working, was a let down, but I still had Tegritol; at least till I turned 38, when I was on such a high dose (to get the same relief) that I was unable to see (double vision), or feel my lips, or drive or walk without feeling the wall to stay balanced. Drug toxicity. My docs all made me quit working and go home; at 38. For 19 years now I've been on 100% Social Security disability. Being a bank vice president is so far in the rear view mirror that it's unrecognizable. I lost everything at first; house, wife, car, stuff; but 19 years later here i am with a paid off small house, 3 paid off older cars, a new more understanding wife, a kid whose about to start college, and a hard fought  $17k college savings, large enough to get him through 2 years at the local community college before student loans are considered. So, I'm doing ok. I even help an old friend of mine by doing minor clerical chores remotely, and he's kind enough to pay me, so that I can participate in the Social Security's "Ticket to Work" program. It makes me feel useful, and although it's not a lot of money, it helps pad the savings.  But it wouldn't be possible without having a friend/employer who understands that, there are simply times when you're going to be unexpectedly offline, due to either the pain or the drugs.

That's me, now here is my answer to your question.  Your descrition doesn't match my description of trigeminal neuralgia pain.  

My pain is Exactly the same as when I was a kid at age 9, the same as when I was running Cross Country & track in high school, the same as when I was out of college as a bill collector, and the same as I had on both of my wedding days (or, as I've had hit me a dozen times while writing this). I just don't fall to the ground and roll on the floor screaming, or crying in my bed for hours, as I did when I was 9. I don't hold my head and face and close my eyes wincing, like I did through age 12. By the time I was 13 I had learned to "look" normal when I wanted or had to. Now, I still held my face occasionally, still do... occasionally... but you see, I learned how to, and can, hold back my reaction to the horror.  It is very much a control thing.  I had my first kiss in pain, my first of many things were in pain. People have described it as a sharp stabbing pain, which I guess could be right.  I've seen "electric shock" which is closer (if the voltage was high enough, I guess). I think the best explanation I've come up with is; "It's like having someone hit you with a cattle prod." Not that the physical device (the rod or bar) itself is germain, but the Voltage is what matters. The other explanation I've heard that is good is, "It feels like a sustained lightning bolt that hits You over and over again."  You could be left sided, right sided, upper jaw, lower jaw... it doesn't matter, I've heard so many agree that That is a good description. But, there are other things about it: it can sometimes feel like it is just a 9 volt battery worth of pain, and sometimes, it's the full blown pain but it turns on and off, on and off, reportedly for hours. The thing is, it is an "origination pain," the most pain a nerve can feel, but it is originating  from where the nerve joins the ponds of the brain, not the other way around. And it is "felt" by you where the nerve ends, in the face. For me, that is, from 1 inch to the left of the outside of my left nostril, about where the nerve exits the bone there, and shoots and dances across my face through the bones, gums, teeth, to the highest point at the top of my eye socket and temple, and as far back as the beginning of my ear. But mainly, my top teeth and upper bone holding the teeth on the left, and that exact spot where the nerve exits the scull, 1 inch left of my nose.

I'm lucky in so many ways. Over the years I've met great doctors. My current neurologist has had trigeminal neuralgia and is currently in remission (lucky guy). And it's nice to have met so many TN sufferers in person over the years. My surgery didn't work, probably because I had had TN for 12 years before getting cut open.  I've had offers, even from the original surgeon, to have a do-over. I just can't bring myself to having my head splayed open again so that they can dig deep inside and recushion the nerve. I've heard too many warnings about the procedures that I've not tried to consider them. I've tried every drug known to have had a positive result, and I make a yearly appointment to talk to a neurologist to see if there is something looming on the horizon that we haven't tried yet. Through it all, only Tegritol  (Carbomezapine) has worked.

My only advice for anyone is, stay away from narcotics if possible. They only make you not care that you're in pain if you take enough of them (I found that at about 100mg of extended release Morphine, 3 times per day), they don't relieve TN pain. I'm so happy to be off of them.

Best of luck to you, and hang in there. No matter what you have, you're not alone- people really do care.

Chief


Helpful - 0
233622 tn?1279334905
It is not good to hear that eventuatlly there is a tolerance that builds up to the drugs........... :(  Well, at least I am getting relief right now!

LA
Helpful - 0
338416 tn?1420045702
This is from Medscape, so it's extremely technical... but it says that anti-epileptic drugs are better than analgesics for treating TN.  (I'll break up the paragraphs so people can read it!)

"Trigeminal neuralgia (TN) is reputed to be one of the most painful conditions in human experience. Thus, many treatments, both medical and surgical, have been developed for this relapsing and remitting, paroxysmal stabbing or electrical, facial pain syndrome.

The likely etiology in many cases is vascular compression of the trigeminal nerve root entry zone, leading to focal demyelination and aberrant neural discharges. MRI may disclose neurovascular contact, although not with sufficient sensitivity or specificity to substitute for careful clinical diagnosis.

In treating TN, antiepileptic drugs are superior to traditional analgesics. Carbamazepine is the first choice drug. Additional drugs for which there is evidence of efficacy include oxcarbazepine, baclofen, gabapentin, lamotrigine and phenytoin. Many patients eventually experience tachyphylaxis or may not tolerate effective doses.

Surgical options include: microvascular decompression; balloon compression; radiofrequency thermocoagulation or glycerol rhizotomies; and subcutaneous alcohol branch blockade. Stereotactic gamma knife radiosurgery is a further option.

Motor cortex stimulation and transcranial magnetic stimulation, although having shown initial promise for trigeminal neuropathic pain, seem to be ineffective for classical TN. The choice of drug, whether or when to operate, and which procedure to choose should be individualized to the particular needs and conditions of the patient."

**********
Helpful - 0
233622 tn?1279334905
I have my t-spine MRI tomorrow.
I have found significant relief from Trileptal.  I wish I had started something a couple of years ago.

Every body is different. If I helps you then that is the way to go! :)

LA
Helpful - 0
Avatar universal
ELT
Actuallly, he put me on one, without telling me what the pain was.  Just that it could be neuropathic and we treated it with gabapentin/neurontin.  I had to use too high a dose after a bit, so I was switched to lyrica.

I haven't taken what lyrica I have for a variety of reasons.  Mostly so I could explain to neuro and whoever is running tests, just where I hurt and how.  In case it matters.  

We'll see.  I just spoke to the tech who will be giving me my ep in april on the phone today for almost half an hour.  LOL  nice man.

Thanks again.  Maybe it will mean MY diagnosis, too.  :)

My latest mri was saturday, and my ep will be in april.  Then I'll see doc again.  

And, it's the ice which is doing the numbing thing.  LOL

Erica
Helpful - 0
233622 tn?1279334905
If I were you I would ask my doctor if I could try one of the anti sezuire meds. If they help then you can be sure it is TN.  That is how I got relief and my diagnosis.  

I resisted the anti sezuire meds at first but finally was glad to try one.  It has given me a lot of relief!

I can't comment on the shingles because I have never had a case..thankgoodness!!  

Can't be of any help with the alcohol either. But if it helps then it is probably ok. You really do sound like you need so real relief from this pain.  Give your doctor a call!

LA
Helpful - 0
Avatar universal
ELT
I tried, it doesn't seem to be working?

Erica
Helpful - 0
Avatar universal
ELT
On the hike with my lady friends on tuesday, it was snowing.  Every little snowflake made my face itch, and burn, and tingle.  I know what shingles feels like and right now, it's doing it.  

But, the daiquiri is helping.  (It's mostly crushed ice, not as much rum as they call for, I plan on inhaling lots of crushed ice before bed, gotta make it, and myself, last.  LOL)

Thnx for the help, I'll check out the site, now.

Erica
Helpful - 0
233622 tn?1279334905
here is a good link  http******html

I am sure I have TN but also atypical tn as I have on going symptoms that fit.  

If you look at the diagram on the web site you will see that the lower two nerve braches do run near the teeth.  

When I had my first attack of TN I thought for sure it was my teeth. ALL of them on the top right side!!! I was ready to have every one of them pulled!!

Hope you can get some help for this soon.  


LA
Helpful - 0
233622 tn?1279334905
Hi Erica,
I was not even able to touch my head, hair, or face. A slight bump to the bed, a light breeze, and even someone talking sent pain like I have never felt before ripping through my head.

If you have even smashed your finger, stubbed your toe...anything that causes instant mind numbing pain so bad you can't even speak is what it was like.  It comes in waves and lasted about 1 minute or so and then would let up and I could talk again.  

I know I would not have been able to tolerate anything cold.  Once the horrible pain let up it did feel good to have a warm cloth and even the warmth of the shower was ok as long as I had the flow set on low.  

But, that does not mean everyone is like me.  Maybe the cold packs would help others. Something has to help!   I have tried cold packs but still find that the cold sets it off. I am having a very difficult time with TN pain right now because it is so cold outside.  A warm shower always helps me.  

Trigeminal Neuralgia is called the "Suicide Disease" and for good reason.  


LA
Helpful - 0
Avatar universal
ELT
The first time it happened, I was in agony, non stop, all day and night, for a few weeks.  It was a nightmare.  It eased off only to reappear quite quickly, tho not as bad.  

It's done that a few times now.  The difference this time is that it seems to be taking a really, really long time to get to it's worst.  It stays at a point for a week, and I'm fooled into thinking that's as bad as it's going to get, then it gets worse.  It's bad now.  

It's brought me to tears, and if I hadn't recently been sent all over hell's half acres by my insurance company, I would have spent time in emergency rooms to try to get help, it was awful.  Ice packs helped.  I always have a stash of gel packs in the freezer.  LOL

I don't think it's gotten as bad as it's gonna get this time, but, it's been coming on for months now.  

I'll tell you, though, thank goodness for the new fridge with the ice cube dispenser / crusher.  I'm rolling crushed ice around in my mouth, in the form of a strawberry daiquiri.  LOL.  It feels soooooo good.  It's like when you hurt, and getting into a pool feels better?

The sensation in my face is altered, it's much calmer.  If daiquiris are against the rules, how about an iced soda, or something?

Erica
Helpful - 0
233622 tn?1279334905
My very first TN symptoms were painful stabbing up my nose on the right side. Then I started getting the same pain in my right ear. Then I noticed a constant soreness on the right side of my face. I could not find a comfortable way to lay my head on that side.  

When I had an actual attack of TN I was in SO MUCH pain.  My teeth did hurt me, so badly I felt like I could have pulled them out myself!  I had searing pain that went from my teeth up through my check along and around my ear and temple area.  Vicoden didn't even get rid of the pain.  

My TN has been at a low roar here recently because I am on Trileptal.  I still ache but do not have the lightning hot searing pain.  

My sister has TN but hers is located on the top nerve.  Mine seems to be the middle nerve. There are 3 branches of trigeminal nerve on both sides of your face.  One way the doctor knew for sure it was nerve pain was it was like I had a line down the middle of my face.  It was like I had a line right down the middle of my nose and teeth. My left side was perfectly fine, no pain. The right side was very painful including my top teeth on the right side.  

My mom was hospitalized with her first attack of TN about 14 years ago. She was in for a week. Her most recent attack sent her to the ER. So, it can get really BAD.  It can also stay at a low roar.  I always thought I had sinus pain until I started the Trileptal. Now all of the pressure and aching is so much better. I have only been on this medication for 2 weeks.  

LA
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Avatar universal
ELT
Coool, I'm using a daiquari LOL

Erica
Helpful - 0
334876 tn?1229979296
  When I first started getting them I ended up in the ER and was given kolapen (sp) and oxygen but with the oxygen it really helped to stop the pain of it and since I have a gas welder and feel one coming on I will open up the oxygen bottle and breath it in, it helps but still doesn't kill it all the way

  Cowboy
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Avatar universal
ELT
I meant to say thanks, LOL/
Erica
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Avatar universal
ELT
I don't have the eyeball pain at the moment.  My vision was screwy for a cpl weeks, and then my eyeball hurt, in the back of the top part.  like someone squishing their thumbs into the top of my eye sockets.  But, that's cleared up, in the last couple weeks.  

First, in november, my left eyelid started twitching, NON stop.  After four weeks, it let up, but, my eye decided to think it was looking through vaseline on my glasses lens.  For two weeks.  During that time, is when it hurt.  But, it's better, almost, now.  

The facial stuff has been creeping up on me from before the eyelid thing.  It's always there, now, to some degree.  But, it's been getting worse earlier in the day, lasting longer and getting more painful, over the last couple of months.  It's been really gradual.  I kept thinking it would subside without getting really bad, I'm thinking I could be wrong.  I've been wrong before.  LOL

Time to roll a cold one on my face.  :) :)

Erica
Helpful - 0
334876 tn?1229979296
I tend to get alot of the same things as Jen dose but I get a lot of it around my left eye with a stabing pain behind the eye like someone is trying to poke my eye out from the inside out and with a lot of numbness in that side of my face

  Cowboy
Helpful - 0
Avatar universal
ELT
I know it's not physical, been thoroughly checked out that way.  Both dentist and gp.  Xrays all fine.  Nothing looks any different, except sometimes the colour of my lips.  I am not a jaw clencher.  I have had sleep studies, my bf is awake enough in the night, when I'm asleep to know.  LOL

It feels like a giant spasm emanating from my jaw hinge at the moment.  Towards my nose.  I feel like I need to conciously relax my face, like I'm purposely pursing my lips, and squinting.  But, I'm not.  It's weird.  

Then again.  So am I, and it gives me something to blabber on about, LOL LOL.

Erica
Helpful - 0
338416 tn?1420045702
My TN is on my left side only, and it's not nearly that painful!  Sometimes I get sharp pinprick pains in my lip, chin, cheek, or inside my ear.  Sometimes my jaw gets spastic, too.  Mostly my face is just numb on that side, including my forehead, lip, chin, tip of my nose, cheek, and ear.  When it's cold I experience aching pains, rather like a headache in my face.

Your burning, itching, tingling and numbness sounds like neuralgia, but the pains you describe in your teeth and jaw don't sound like neuralgia.  But if you can make the pain go away with a medication that works by altering brain chemistry, then it might be some sort of neuropathic pain.

That's a weird one, Erica!  I don't think you're silly for thinking it's TN - it's as good an explanation as any.
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