Trigeminal neuralgia

Posted on Multiple Sclerosis

Trigeminal neuralgia – Radiation therapy improves painful condition associated with multiple sclerosis

MRI MS and the spine


Stereotactic radiation is an effective, long-term treatment for trigeminal neuralgia: a painful condition that occurs with increased frequency in patients with multiple sclerosis (MS). Radiation is noninvasive and has less negative side effects than other treatments, according to the longest follow-up in a study of its kind presented October 31, 2010, at the 52nd Annual Meeting of the American Society for Radiation Oncology (ASTRO).

Multiple sclerosis is a progressive neurological disease affecting about 300,000 Americans where the body’s immune system attacks its own nerve cells, affecting the ability of the brain to communicate with the spinal cord. Trigeminal neuralgia is an intensely painful condition caused by dysfunction of the trigeminal nerve, which is one of the nerves that innervates the face. People living with MS see a significantly increased incidence of this problem.

“We studied patients for a median of five years after treatment, which is the longest period of follow-up ever completed,” Tejan Diwanji, lead author of the study at the University of Maryland, School of Medicine in Baltimore, said “Our study shows that radiosurgery using Gamma Knife is a proven alternative to surgery or anti-epileptic drugs.”

The study was designed to determine the long-term effectiveness of treating trigeminal neuralgia in MS patients with Gamma Knife radiosurgery.

Stereotactic radiation is a specialized type of external beam radiation therapy that uses focused radiation beams to target a well-defined area. It is most often used for tumors of the brain, but in this case, doctors targeted a nerve root, relying on detailed imaging and computerized three-dimensional planning to deliver the radiation dose with extreme accuracy while sparing the surrounding tissue to reduce side effects.

Stereotactic radiation therapy, sometimes called radiosurgery, refers to a single or several treatments to the brain. Doctors in this study used GammaKnife. Other brand names for stereotactic radiation include Axesse, CyberKnife, Novalis, Primatom, Synergy, X-Knife, TomoTherapy or Trilogy.

The study involved 13 MS patients with trigeminal neuralgia who were treated with radiosurgery at the University of Maryland between 1998 and 2001 and were followed for a median of five years after treatment.

“We need more long-term studies to confirm the positive and lasting outcomes of radiosurgery, then it could become the treatment of choice for MS patients afflicted with trigeminal neuralgia,” Diwanji, said. “I encourage people with MS suffering from trigeminal neuralgia to talk to their doctor about consulting a radiation oncologist to see if they would be good candidates for radiosurgery.”

Posted on Multiple Sclerosis, Pain Management, Rheumatoid arthritis

Trigeminal Neuralgia Treatment Explained by Neurologist

Trigeminal Neuralgia Treatment Explained by Neurologist - YouTube

Trigeminal Neuralgia Treatment Explained by Neurologist

0:27​ Causes

2:46​ Tegretol (carbamazepine)

4:50​ Trileptal (oxcarbazepine)

5:14​ Neurontin (gabapentin)

6:08​ Other Meds

6:42​ Rhizotomy

8:59​ Radiosurgery

10:01​ Microvascular Decompression

11:36​ Comparison of Procedures



Posted on Multiple Sclerosis

Multiple Sclerosis Vlog: Trigeminal Neuralgia HURTS!

Image result for Multiple Sclerosis Vlog: Trigeminal Neuralgia HURTS! aaron


Trigeminal Neuralgia HURTS! Trigeminal Neuralgia is often described as some of the worse pain a human can experience. In this video I’m going to teach you about it. Want to better understand why trigeminal neuralgia hurts so badly? Then start watching this vid right now!

Posted on A to Z of Medical Conditions, Multiple Sclerosis

Peripheral nerve block provides some with long-lasting pain relief for severe facial pain




Trigeminal neuralgia

Trigeminal neuralgia

A new study has shown that use of peripheral nerve blocks in the treatment of Trigeminal Neuralgia (TGN) may produce long-term pain relief.

TGN is a condition involving sudden episodes of severe facial pain that significantly reduces quality of life in those affected. When medication fails to control the pain, some patients turn to




invasive procedures that require a high level of expertise and can result in long-standing numbness. Peripheral Trigeminal Nerve Blocks (PTNB), a procedure in which a numbing medication is injected at the sites where the problem nerve reaches the face, is a promising alternative to the riskier, ganglion-level procedures, although its efficacy in both short-term and long-term management of TGN has not been well studied.

In a case series in this week’s American Journal of Emergency Medicine, Michael Perloff, MD, assistant professor of neurology at Boston University School of Medicine, examines nine patients with TGN treated with PTNB. He finds that all nine had immediate relief of their pain after the procedure, with most reporting that they were pain-free. In addition, six of the nine patients noted continued pain relief from a range of one to eight months following the procedure, with two of them having complete resolution of their pain months after the injections.




Perloff, also a neurologist at Boston Medical Center, sees these results as a promising step for treating patients with TGN. “PTNB can be a simple, safe alternative compared to opioids, invasive ganglion level procedures or surgery.”

Posted on A to Z of Medical Conditions

Trigeminal neuralgia – what are the signs and symptoms of Trigeminal neuralgia?




Trigeminal neuralgia is sudden, severe facial pain. It’s often described as a sharp shooting pain or like having an electric shock in the jaw, teeth or gums.It usually occurs in short, unpredictable attacks that can last from a few seconds to about two minutes. The attacks stop as suddenly as they start.

In most cases trigeminal neuralgia affects part or all of one side of the face, with the pain usually felt in the lower part of the face. Very occasionally it can affect both sides of the face, although not usually at the same time.




Diagram of trigeminal nerve

People with the condition may experience attacks of pain regularly for days, weeks or months at a time. In severe cases attacks may occur hundreds of times a day.

It’s possible for the pain to improve or even disappear altogether for several months or years at a time (remission), although these periods tend to get shorter with time.

Some people may then go on to develop a more continuous aching, throbbing and burning sensation, sometimes accompanied by the sharp attacks.

Living with trigeminal neuralgia can be very difficult. It can have a significant impact on a person’s quality of life, resulting in problems such as weight loss, isolation and depression.

Read more about the symptoms of trigeminal neuralgia.

When to seek medical advice

See your GP if you experience frequent or persistent facial pain, particularly if standard painkillers, such as paracetamol and ibuprofen, don’t help and a dentist has ruled out any dental causes.

Your GP will try to identify the problem by asking about your symptoms and ruling out conditions that could be responsible for your pain.

However, diagnosing trigeminal neuralgia can be difficult and it can take a few years for a diagnosis to be confirmed.




Read more about diagnosing trigeminal neuralgia.

What causes trigeminal neuralgia?

Trigeminal neuralgia is usually caused by compression of the trigeminal nerve. This is the nerve inside the skull that transmits sensations of pain and touch from your face, teeth and mouth to your brain.

The compression of the trigeminal nerve is usually caused by a nearby blood vessel pressing on part of the nerve inside the skull.

In rare cases trigeminal neuralgia can be caused by damage to the trigeminal nerve as a result of an underlying condition, such as multiple sclerosis (MS) or a tumour.

Typically the attacks of pain are brought on by activities that involve lightly touching the face, such as washing, eating and brushing the teeth, but they can also be triggered by wind – even a slight breeze or air conditioning – or movement of the face or head. Sometimes the pain can occur without any trigger at all.

Read more about the causes of trigeminal neuralgia.

Who’s affected

It’s not clear how many people are affected by trigeminal neuralgia, but it’s thought to be rare, with around 10 people in 100,000 in the UK developing it each year.

Women tend to be affected by trigeminal neuralgia more than men, and it usually starts between the ages of 50 and 60. It’s rare in adults younger than 40.

Treating trigeminal neuralgia

Trigeminal neuralgia is usually a long-term condition, and the periods of remission often get shorter over time. However, most cases can be controlled with treatment to at least some degree.

An anticonvulsant medication called carbamazepine, which is often used to treat epilepsy, is the first treatment usually recommended to treat trigeminal neuralgia.

Carbamazepine needs to be taken several times a day to be effective, with the dose gradually increased over the course of a few days or weeks so high enough levels of the medication can build up in your bloodstream.

Unless your pain starts to diminish or disappears altogether, the medication is usually continued for as long as necessary, sometimes for many years.

If you’re entering a period of remission and your pain goes away, stopping the medication should always be done slowly over days or weeks, unless you’re advised otherwise by a doctor.

Carbamazepine wasn’t originally designed to treat pain, but it can help relieve nerve pain by slowing down electrical impulses in the nerves and reducing their ability to transmit pain messages.

If this medication is ineffective, unsuitable or causes too many side effects, you may be referred to a specialist to discuss alternative medications or surgical procedures that may help.

There are a number of minor surgical procedures that can be used to treat trigeminal neuralgia – usually by damaging the nerve to stop it sending pain signals – but these are generally only effective for a few years.

Alternatively, your specialist may recommend having surgery to open up your skull and move away any blood vessels compressing the trigeminal nerve.

Research suggests this operation offers the best results in terms of long-term pain relief, but it’s a major operation and carries a risk of potentially serious complications, such as hearing loss, facial numbness or, very rarely, a stroke.

Read more about treating trigeminal neuralgia.