Facial Pain: When a Nerve Is a Live Wire

Of all the places in the body that can hurt, the face might seem the strangest. But for some people, that's exactly where the agony occurs, and the cause is a nerve gone haywire.

How peripheral nerves involve themselves in pain is sometimes confusing. Here's a handy way to think of the two basic patterns:

#1: The nerve is the messenger. If you have a dental abscess, a facial sunburn or a sinus infection, you can count on pain being present. Where does it come from? Special nerve endings detect the tissue-injury and generate electrical impulses. The peripheral nerves carry these impulses into the brain. The peripheral nerves didn't CAUSE the pain, they're just carrying the bad news. (Don't shoot the messenger!)

#2: The nerve itself is the mischief-maker. In some cases the nerve generates abnormal impulses on its own. The nerve is still capable of carrying normal impulses, like those informing the brain that the skin of the face is warm or cold-or that you cut yourself shaving-but generates signals of its own as well that the brain can only interpret as painful.

When peripheral nerves generate bolts of pain in the forehead, eye, cheek or jaw, it's called trigeminal neuralgia. This technical term can be broken into its parts, starting at the end and working forward. "Algia" means pain. A "neur-algia" means nerve-pain. Finally, "trigeminal" is the name of the nerve involved. So "trigeminal neuralgia" means pain caused by the trigeminal nerve. We have two trigeminal nerves, one for each side of the face. They are among the largest nerves in our heads.

An older term for trigeminal neuralgia was "tic douloureux." This bears explaining. A "tic" is a sudden, brief movement. "Douloureux" is the French word for "painful." So a "tic douloureux" means that a sudden, brief movement and a pain occur together. However, this terminology was largely abandoned because it implies that movement is an essential feature. It isn't. When movement is present, it's just as a reaction to the pain.

So what are the usual features of trigeminal neuralgia? First of all, it almost always occurs on just one side of the face. If one of our trigeminal nerves gets involved in this unfortunate condition, it's rare indeed that the second trigeminal nerve would be so unlucky to get involved, too. Or another way of looking at it is this: if the pain switches sides or crosses the midline, then it's probably not trigeminal neuralgia.

Trigeminal neuralgia usually involves brief, but intense jabs of pain, though is sometimes more steady and continuous. It can also get revved-up by external stimuli, like washing the face, putting on make-up, brushing teeth, chewing-and sometimes just talking.

The most usual form of trigeminal neuralgia begins after the age of 50. And, once present, it tends to hang around. Its course-like that of the stock market-fluctuates.

Treatment is not usually curative, but help is still available. Most patients obtain relief through one or a combination of medications that either simmer down the extra nerve-impulses or reduce the effects of the barrage of extra signals that arrive in the brain. Some of their generic names are carbamazepine, gabapentin, baclofen, clonazepam and lamotrigine.

A minority of patients with this condition undertake surgery for it. One surgery involves purposely damaging the trigeminal nerve-fibers where they gather together in a structure called a ganglion. This approach is fairly safe, but produces partial numbness on the face.

Another surgery goes straight to where the trigeminal nerve fibers meet the brain. The surgeon gently separates the nerve from its surrounding tissues. The good part of this procedure is that it doesn't seek to damage tissue. The downside is that the location for the surgery is at an important cross-roads for many nerve and brain pathways, so a complication can be devastating. While some people get long-lasting relief from the surgeries, others obtain just temporary respite.

While the foregoing summary of treatments sounds gloomy, it's important to realize that most people who seek medical treatment for their trigeminal neuralgia are able to arrive at a happy point where pain is minimized and quality of life is maximized. The neuralgia no longer rules their lives; instead, they're in control of the neuralgia.

(C) 2005 by Gary Cordingley

Gary Cordingley MD, PhD, is a clinical neurologist, teacher and researcher. For more health-related information, see his website at: http://www.cordingleyneurology.com


Free Quran in All Languages

Free Tafsir Books

Hemorrhoids Treatment - A Variety of Options

A variety of options exist for hemorrhoid treatment including surgery,... Read More

?Get Rid of Tendonitis ? Now!? Advice From An Expert?

Tendons are ropes of fibrous tissue that connect muscles to... Read More

Back Pain & Muscle Pain - Effective & Natural Pain Treatment Alternatives

Pain and Stress. They seem almost to go hand in... Read More

Zyprexa Lawsuits

Zyprexa is an antipsychotic medication that works by changing the... Read More

How Is Mold Like AIDS?

Don't laugh. Both get a lot of coverage in the... Read More

Bextra and Vioxx -- Tips for Arthritis Relief Without Them

The recent withdrawal of Vioxx and Bextra from the marketplace,... Read More

Three Questions People Are Asking About Health Care in America

Q. Why is there so may uninsured people in America?A.... Read More

Accutane Side Effects Lawyer: Hair Loss, Depression, Suicide

You probably know the drug isotretinoin by its trade name,... Read More

Stem Cell Breakthrough: Can You Now Make Your Own?

Over the past few years, stem cells have been getting... Read More

Substance Abuse Attitude Testing by a Standardized Survey

This is a short overview of a questionnaire used for... Read More

10 Steps To Detoxification

Technology. We live in a grand time of technological development.... Read More

How Safe Do You Feel Going To Hospital To Be Cured

There has been a lot of concern in Australia over... Read More

A Closer Look at Lower Back Pain Relief

As many as 8 out of 10 adults will experience... Read More

Implant Dentistry ? The Convenient and Safe Alternative to Dentures

If you are missing a tooth or a group of... Read More

Bextra and Vioxx -- Alternative Medications Have Warnings, Too

At the urging of the Food and Drug Administration, the... Read More

Vioxx Side Effects : Are You Suffering?

Have you ever taken the drug Vioxx or celebrex? In... Read More

Are Drug Companies Destroying The U.S. Health Care System?

The U.S. government's annual bill for healthcare spending ? $3,925... Read More

rX My Heart and Hope to Die

This must be a mistake! How could his drug costs... Read More

Hypertension & High Blood Pressure: How To Improve Life Threatening Weight-Related Diseases

The American Heart Association estimates that one of three Americans... Read More

Be Informed About The Medications You Take

The recent withdrawal of the prescription drugs Vioxx and ... Read More

A Closer Look at Neck Pain Relief

Neck pain afflicts many people at some point in their... Read More

Seroquel Side Effects: Effects of Seroquel Worth the Risk?

Seroquel is an atypical antipsychotic drug that is used to... Read More

?Foot Pain Relief At Last!?

"As an arthritis specialist, one area that I see people... Read More

Prescription Drug Side Effects: Treating From The Outside Or The Inside?

Throughout time there have always been two opposing points of... Read More

Pharmaceuticals: The Next Frontier in America?s War on Drugs

America's war on drugs, which has been fought in the... Read More