Trigeminal Neuralgia*

Posted by lamerex4 @lamerex4, Jun 23, 2016

My 92 year old father was diagnosed with Trigeminal Neuralgia more than a decade ago. For a long time Amitriptyline kept the 'strikes' at bay. He became symptomatic again last October. In March they did a Gamma Knife radiation treatment. This halted his symptoms for about 6 weeks. Two weeks ago he started having daily 'strikes' again. His PCP switched him from Amitriptyline to Lyrica. Now that he is weaned completely off the Amitriptyline and on the full dose of Lyrica he is having 'strikes' several times a day. The local neurosurgeons won't consider surgery, but we are desperate. Any insights at all on any therapeutic modalities would be appreciated. Acupuncture was not effective.

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@mooneagle

Is there anyone in this particular group who has trigeminal neuralgia? I have been suffering with it for 16 years and I just about can't take the pain anymore. The pain is one-sided, as it usually is, and it covers the whole right side of my face from the chin up to my forehead. It affects my right eye when I have the pain and I can't see very good at that time. It was caused by a dentist hitting the trigeminal nerve (5th cranial nerve) while giving me a novocaine shot in my bottom right jaw. Oh, he joked and said the pain will stop after the novocaine takes affect. It took over a year for me to figure out that the excruciating pain I was having was not due to bad teeth. I have been going monthly to a pain management doctor for the past 15 years and all he could do for me was try every medicine that treats nerve pain, a whole slew of anti-epileptic drugs (didn't work), morphine, fentanyl, oxycodone, methadone, and other I can't remember. Now for the past 12 years I have been on Norco 10 mg with 325 mg of acetometaphin along with Valium, Nothing really works, so he has allowed me to take up to six Norco tablets and 3 Valiums in one day, and then use a sleeping pill (Seroquel 20mg) if the pain hasn't calmed down. I sleep a lot. There are days when I have only minimal pain - 5 to 6 on the pain scale - but the bad days are 10+++ (not making this up). Eating, talking and the wind are the triggers for this pain, so I'm somewhat stuck in the house unless it is warm and not windy. I have had 10 stellate ganglion blocks and they did nothing. So his only other idea was to sever the nerve. The trigeminal nerve gives feeling to the face, and severing the nerve is really not an option for me because he said the right side of my face might droop a bit, and also that the nerve could grow back. He said that, if it were to grow back, it would be "mad". That's the word he used ... "mad" ... because that's the term used in relation to nerves that are fiddled with. So I'm wondering if anyone else has this monster of a nervous system disorder and if anyone has had any relief. Thanks for your time.

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I had gamma-knife procedure and am doing much better. I do still have pain on the right part of face from my forehead to my cheek. Still taking trileptal but functional. No extreme pain.

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@mooneagle

Is there anyone in this particular group who has trigeminal neuralgia? I have been suffering with it for 16 years and I just about can't take the pain anymore. The pain is one-sided, as it usually is, and it covers the whole right side of my face from the chin up to my forehead. It affects my right eye when I have the pain and I can't see very good at that time. It was caused by a dentist hitting the trigeminal nerve (5th cranial nerve) while giving me a novocaine shot in my bottom right jaw. Oh, he joked and said the pain will stop after the novocaine takes affect. It took over a year for me to figure out that the excruciating pain I was having was not due to bad teeth. I have been going monthly to a pain management doctor for the past 15 years and all he could do for me was try every medicine that treats nerve pain, a whole slew of anti-epileptic drugs (didn't work), morphine, fentanyl, oxycodone, methadone, and other I can't remember. Now for the past 12 years I have been on Norco 10 mg with 325 mg of acetometaphin along with Valium, Nothing really works, so he has allowed me to take up to six Norco tablets and 3 Valiums in one day, and then use a sleeping pill (Seroquel 20mg) if the pain hasn't calmed down. I sleep a lot. There are days when I have only minimal pain - 5 to 6 on the pain scale - but the bad days are 10+++ (not making this up). Eating, talking and the wind are the triggers for this pain, so I'm somewhat stuck in the house unless it is warm and not windy. I have had 10 stellate ganglion blocks and they did nothing. So his only other idea was to sever the nerve. The trigeminal nerve gives feeling to the face, and severing the nerve is really not an option for me because he said the right side of my face might droop a bit, and also that the nerve could grow back. He said that, if it were to grow back, it would be "mad". That's the word he used ... "mad" ... because that's the term used in relation to nerves that are fiddled with. So I'm wondering if anyone else has this monster of a nervous system disorder and if anyone has had any relief. Thanks for your time.

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@vickylynn I appreciate the update, Vicky. I'm glad to hear that you continue to do better.

Teresa

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@mooneagle

Is there anyone in this particular group who has trigeminal neuralgia? I have been suffering with it for 16 years and I just about can't take the pain anymore. The pain is one-sided, as it usually is, and it covers the whole right side of my face from the chin up to my forehead. It affects my right eye when I have the pain and I can't see very good at that time. It was caused by a dentist hitting the trigeminal nerve (5th cranial nerve) while giving me a novocaine shot in my bottom right jaw. Oh, he joked and said the pain will stop after the novocaine takes affect. It took over a year for me to figure out that the excruciating pain I was having was not due to bad teeth. I have been going monthly to a pain management doctor for the past 15 years and all he could do for me was try every medicine that treats nerve pain, a whole slew of anti-epileptic drugs (didn't work), morphine, fentanyl, oxycodone, methadone, and other I can't remember. Now for the past 12 years I have been on Norco 10 mg with 325 mg of acetometaphin along with Valium, Nothing really works, so he has allowed me to take up to six Norco tablets and 3 Valiums in one day, and then use a sleeping pill (Seroquel 20mg) if the pain hasn't calmed down. I sleep a lot. There are days when I have only minimal pain - 5 to 6 on the pain scale - but the bad days are 10+++ (not making this up). Eating, talking and the wind are the triggers for this pain, so I'm somewhat stuck in the house unless it is warm and not windy. I have had 10 stellate ganglion blocks and they did nothing. So his only other idea was to sever the nerve. The trigeminal nerve gives feeling to the face, and severing the nerve is really not an option for me because he said the right side of my face might droop a bit, and also that the nerve could grow back. He said that, if it were to grow back, it would be "mad". That's the word he used ... "mad" ... because that's the term used in relation to nerves that are fiddled with. So I'm wondering if anyone else has this monster of a nervous system disorder and if anyone has had any relief. Thanks for your time.

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that is great. I go to see the Neurosurgeon, on the 13th, hoping it helps me.

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@mooneagle

Oh dear Katydid (LOVE your user name) ... Would you mind telling me how and when you started feeling the facial pain? What side of your face is affected? Yes Katydid, eating and talking plus wind and air conditioning are the most common triggers in my case, and it sounds like they are for you too. I used to ride my bike religiously up until the pain began. I want to give you as much advice as I can because you are in the same spot as I was 16 years ago. So, here's my story. I am a bit of a writer, but haven't published yet - usually children's stories - but the pain has stopped the stories from forming in my mind.

In Aug of 1999 I went to the dentist to have teeth cleaning done on my bottom right teeth. Well, this dentist was a 3rd year resident at a prestigious teaching hospital and he was about to go into practice with a dental group in October 1999. And, as my mother and I did for many years while she was still alive (died in 1969), she and I always went to dental schools to have our teeth worked on because the cost was nominal. So that's why I decided to choose this dental school connected to the teaching hospital. He started to give me the novocaine shot in the right lower jaw when I made a screaming noise and jumped out of the chair - luckily he had already taken the needle out of my jaw. Jokingly, he said: "Oh, I must have hit a nerve. Don't worry, you won't feel any pain now because the novocaine will take it away." And it did. After that I didn't think about what had happened. Then the creepy crawlers of nerve pain began a few weeks later, and I just figured it was my bad teeth, which I've always had. Now I am going to digress a bit (which I do a lot because Norco makes me .... uh, loooopeeee at times.). DON'T drink as much caffeinated and carbonated pop as I do. I am a diet Pepsi addict. I began drinking regular Pepsi when I was 15 and then graduated to diet when it first came out. No matter what I'm told about how bad caffeine is, if I'm going to have this pain no one is going to take away one of my only pleasures in life! Not drinking the pop wouldn't help anyway.

Beginning in 2001 the MDs I saw put me on every type of drug used for TN - mostly anti-epileptic drugs which were completely ineffective, phenobarbital, methadone, mexitil, oxycodone, morphine tablets .. I can't remember all of the others right now. In 2004, I started going to a pain management clinic instead of individual neurologists, and they started me on Norco 325 mg with ibuprofen in it and Valium 10mg 3 times a day. However, after taking Norco's 325 mg (hydrocodone with ibuprofen) since 2004 it has lost most of its effectiveness. Beginning last year they now allow me to take 2 at a time up to 6 a day along with the Valium. As an aid to help me sleep, I am on Seroquel 20 mg, which I don't take often because I sleep toooo long - over a day once. There is never a day when I am without pain - but not always severe enough to make me stop what I'm doing. But, I've never gotten below a 4 on the pain scale.

The ONLY drug that gave me and relief was Lyrica - used for nerve pain in fibromyalgia mostly (I'm sure you've seen the commercials). I took it for almost two months in 2006 and was in low-pain heaven - never having pain higher than maybe a 4 to 5 on the pain scale - and I can handle that. But I developed one of its side effects - eye vision problems which caused such blurriness that I was not even able to walk around the house without saying: "Oh, hello wall, how did you get there?", and not even able to read or watch TV. I am an AVID reader and I was devastated. So I had to come off the Lyrica and be restarted and tried again on all those other drugs until finally it was decided that I should just take the 325 mg of Norco with ibuprofen in it along with 10 mg of Valium.

I have had 6 stellate ganglion blocks steroids shot into the neck getting as close to the brain stem as they can. The trigeminal nerves come out of the brain stem with one branch going up the left side and the other going up the right side. I USED to joke around with the doctors and say: "Oh, I'm just a bundle of nerves!". I no longer joke around. It took almost two years to even be diagnosed with TN because I felt my pain was from infections and rotten teeth. The nerve blocks did not work because the pain was still on the right side of my face when I came out of the sedation. One MD had the nerve (pun) to say that I was lying. Why would I go through the procedure and then have to pay the cost of it if I thought they wouldn't work?

Now, seriously, learn as much about TN by searching the internet. Especially (!!) Google 'brain stem' and other sites that will give you information about the cranial nerves (there are 12 and they all go in different directions to do their jobs.) The trigeminal nerve is the 5th cranial nerve. Study up on your condition. The trigeminal nerve is the 5th cranial nerve.

You asked if there is anything you can take or do until your neurologist appointment in two weeks. I can suggest but I don't want it thought that I am prescribing any one thing over another. Before all those drugs I was on, I took OTC ibuprofen 800 mg about 4 times a day until my stomach told me to stop doing that. My husband was sweet and tried to help by giving me small hot wet towels to put on the right side of my face until I told him to please put a plastic bag on my pillow first! At first, that did help a bit, like about a few minutes, but you might try a small heating gel pack. At times, I still use one.

Over the past 16 years, I have been to the ER 10 times with intractable pain. My doctor isn't on staff there but they called him the first time I came in with the pain (it was midnight!) and he said to start me on a morphine drip. It made me fall asleep, which was nice, but the pain wasn't gone when it was time for me to go home - it was less though. I've never been admitted and there would be no sense to that, at least in my case. But when I got home, the pain came back, luckily not at a 10+++. And, yes, sorry to scare you - can't say this will happen to you - but I have had 10+++ pain. The last two times I've been to the ER (last August and November) the ER MD who saw me took the time to read my computer chart of all my prior visits, and I heard her say: "This is ridiculous." On her own she decided to give me one intravenous injection of a medication called Dilaudid - which I've been told is 10 x stronger than morphine. I don't know, maybe it is, but the ER at my hospital now knows that if I come in with a high pain score, I am to be given the Dilaudid. Katydid - it was a miracle to feel no pain anywhere, not even in the broken right foot which I had broken a week earlier and for which the ER me in a cast. Like I said, 2 Norco's at a time is a lot to take but one does what one needs to do - only if your doctor says you can - and I fell down three stairs and broke my right foot because I was loooopeeee !!!

I will have you on my mind Katydid until I hear back from you, and please do contact me through this website and let me know. I am anxious for you, but I am also encouraged for you because you have taken the first step toward being your own ADVOCATE. Being you own health-care advocate is knowing all you can about your condition AND by asking questions ... lots of questions until you feel you understand your problem and what treatment the doctor has planned for you. AND, most importantly about asking questions - now don't forget to do this - bring with you a list of your concerns, symptoms, and questions that you want answered. Some MDs don't like inter-active patients, so if you feel this neurologist is giving you the brush off find another one. I saw 3 neuros before I found the MD I see now. What still amazes and seriously aggravates me is that some MDs don't want to treat a TN patient. I have had two ER docs tell me straight to my face (this was early on when I first knew the diagnosis) that since they couldn't SEE my pain they wouldn't treat me because I was only there to get narcotics ... drug seeking they called it. If you ever get an MD say that to you - an ER doc or one in the office - do what I did. I called the medical director of the ER and the hospital and told him what happened and gave him the names of the two MDs who said what they said to me, and I found out that they were severely reprimanded. This is an example of what I said above - Katydid you MUST BE YOUR OWN ADVOCATE !!!!

I wish they had emoticons on this site because some of the good ones can tell someone's story so well. But I've said enough for now because my own pain is acting up. It's my own fault. Today we somehow got a 68 degree day (I live in a suburb 15 miles west of downtown Chicago), and I forgot that the window behind me is open ... aaahhh the warm wind. Don't let warm wind fool you ... wind is wind.

Like I said I will have you on my mind Katydid, and writing all of this to you has just become a story in my mind ... which hasn't happened in a long time. May I ask your permission to use your name, Katydid, as the name of the 8-week old female kitten I am getting tomorrow. We are feline lovers in this house, and over the past 22 years we have had 11 (not all at the same time - but it wouldn't have bothered me at all .... yeah, I'm THE cat lady in the neighbor). I better not go any further, first because of the pain and second because I need to get my pencil and paper to start writing my story. Always use a pencil in case you need to erase - which I always have to do to find just the right word. Guess what the title will be: Katydid. The love and empathy an animal can give a human being. EMPATHY - always show that to others or at least have it inside of you. It isn't sympathy. I have empathy for you because I can place myself in your position of living with this pain monster.

P.S. I sent two picture files and I hope they show up because I don't see them in this reply. Take care. MoonEagle (Judy)

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I hope you don't mind but I am going to share this with my mom's new pain Dr and her previous pain dr. As well my dentist as he said he did not believe damage like this could be done by dental procedure.

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@suzeee39

I am sorry, I feel bad for anyone who has to endure this!

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Anna I was wondering how you made out? I have not been around and check my e-mails rarely. I would like to update that I am living without any pain or medication. I have numbness on and off on the top and the side of my head. It feels funny but can live with that. I am done with doctors on TN and am living a normal life. I had my teeth done to look human again. I just came back from a traveling vacation along the east coast. I am going back to work June and never could believe that would happen. I am at peace and fill each day with doing something no matter what it is. When you have been where we were, all things are in your grasp. Regard Carmelo

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@suzeee39

I am sorry, I feel bad for anyone who has to endure this!

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Colleen I would like to post a reply to you the moderator. I was recently involved in my daughter's life, once again and helped her go through some dishearten news about her medical issues. I could not have helped her through being on all that emotional meds and be strong for her, she needed that from her dad. I am happy to say round one went very well and will deal with the second and hope the final round of her issues. I want people to know that you have to be your own advocate to get results that work for you and you alone. I am giving you that information to share with new and existing people that there is a light at the end of the tunnel, you have to seek it.

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@suzeee39

I am sorry, I feel bad for anyone who has to endure this!

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You are so right, @carmelo1morrone. It is important to advocate for yourself, or for a family member. Patients are the experts of their bodies and as such are a necessary part of the care team. I'm glad that you were able to help your daughter through this most recent bout of difficult times.

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Well, I had the MVD, about a month ago. At first there was no pain, except for the incisional pain. Now I am getting intermittent pain, I am hoping this is temporary. The Neurosurgeon said it could take about 6 months for the swelling to go completely down. I am praying it works.

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@annamh

Well, I had the MVD, about a month ago. At first there was no pain, except for the incisional pain. Now I am getting intermittent pain, I am hoping this is temporary. The Neurosurgeon said it could take about 6 months for the swelling to go completely down. I am praying it works.

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@annamh Hello Anna:

Thank you for reporting back on your surgery. I hope that your current level of discomfort will be reduced as time goes on. Are you currently taking any medication for the pain?

I wish you well in the coming months. I would enjoy hearing from you as you continue the recovery process.

Teresa

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I had gamma knife surgery almost a year ago. It helped one portion of my face but not around my eye toward my ear and above. Not sure if I want any more procedure or continue on meds.

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