Trigeminal Neuralgia / Pain in face treatment and remedies


Pain in face – Trigeminal neuralgia

NERVOUS SYSTEM – Pain in face – Trigeminal neuralgia



Worst of all neuralgic pain is said to be the trigeminal neuralgia pain since it occurs in the face i.e., near all our special senses. Its intolerable intensity, recurrent attacks and persisting character make every sufferer most worried.
As spinal nerves connect the spinal column and the periphery, cranial nerves connect the brain and the periphery. There are 12 pairs of cranial nerves. They mostly take care of all special senses i.e. sight, hearing, smell, taste and senses. Trigeminal nerve is the fifth cranial nerve.
Trigeminal nerve – has sensory (transmitting sensations) as well as motor (action) functions. It supplies skin and mucous membrane of head and muscles of jaw. It transmits sensations
from cornea of eye, tympanic membrane of ear, skin of the face, anterior two third of the tongue, mucous membrane of mouth, cheek and throat. Dentists benumb this nerve before extracting any tooth, so that we are not aware of any pain during extraction. Without this nerve, one cannot have
  • Sensations in face (touch, temperature and pain)
  • Temperature and position of the food in the mouth
  • Good saliva secretion to comfort easy swallowing
  • Good lachrymal secretions to care and wash eyes continuously Clenching of teeth
  • Good mastication process (grinding the food in mouth) since they cannot locate food
Trigeminal neuralgia medically refers to excruciating, jolting, intermittent, shooting neuralgic pain in the face on the pathway of the trigeminal nerve. It is otherwise called ‘Tic douloureux’
(French word) which means spasmodic painfulness. The pain flashes of trigeminal neuralgia often makes one fear to live.
Incidences 

Females over 40 years and elderly peoples seem to be the most common victims. Anyhow, it can occur in any age group irrespective of sex. Most often, many sufferers would state that exposure to cold breeze or direct air-conditioned air as the precursor of the complaint. It occurs usually in single side and rarely on both sides.
Pathology – The fifth cranial nerve, i.e., Trigeminal nerve, is named after its three branches – Ophthalmic nerve, Maxillary nerve and Mandibular nerve. Altogether, they provide the brain with all the information about sensations felt in the face.
  • Ophthalmic nerve carries sensation to brain from eye, upper eyelids and forehead
  • Maxillary nerve carries sensations from lower eyelid, nose, cheek and upper lip
  • Mandibular nerve carries sensations from lower lip, jaw and mucous membrane of mouth and throat. It also helps in actions like biting, chewing, and swallowing.
Any flickering or disturbance in concerned branch (branches) may cause pain or altered sensation or loss of sensation in the respective area. Usually triggers cause violent pain and twitching.
Causes – Trigeminal neuralgia can be caused by innumerable factors and are classified as below:
  • Primary , i.e., cause from within itself – infection, inflammation, irritation and de-myelination process
  • Secondary , i.e., taking roots from others – for example – after dental fillings or extractions or
    after viral infections / herpes / cold or after compression of nerve in any of the places in pathway i.e., by blood vessels / swellings / tumours or after multiple sclerosis or meningitis or other neurological problems or after injury / accidents, etc.
But many a time, causes remain obscure and vague.
Symptoms 

Even though there may be a variety of complaints, patients commonly complain of nothing but pain, pain, pain… Onset may be gradual or all of a sudden. Pain usually occurs in flashes, but sometimes it may be persisting like stabbing pain. Mostly it would last from a few seconds to 2 minutes. Its incidences are more commonly seen in the middle and lower part of face and vary from person to person in type, intensity and suffering period, depending upon the involved nerve fibres. Waxing and waning may occur in course of suffering and treatment. The common symptoms are
  • Erratic / excruciating / violent pain in face (cheek, jaw, eyes) nose and throat
  • Lightning / electric / cutting / stabbing / pricking / tearing / squeezing type of pain in face
  • Pain travels / radiates over the face
  • Recurrent bouts of attacks even with mild trigger
  • Altered sensation or numbness or tingling sensation (feeling of pricking pins) with weakness in the parts involved
  • Unpleasant feeling in the face – tickling, pricking, creeping, annoying, etc.
  • Anxiety, tension, restlessness and sleeplessness with fear of pain
  • Difficulty in chewing and identifying the position of the food in the mouth
  • Dryness of mouth due to lowered secretion of saliva
  • Dryness or irritation or ulcers of eyes due to lowered lachrymal secretions
Triggers – may vary from patient to patient. For example – even a pleasant breeze can be felt as a cyclone with excruciating pain or the touch of a soft towel will be felt as sharp pricking needles. Common triggers are touch, pressing, eating, biting, swallowing, gurgling, brushing, shaving, talking, smiling, laughing, crying, make-up, breathing heavily, blowing nose, etc. Often, sufferers go still without any movement to get the pain settled.
Diagnosis and investigation – It is essential to do clinical examination with detailed case study to plan for treatment. Often they provide a clue to the point of disease / complaint origin / diagnosis / plan of treatment. To arrive at a clear final diagnosis, the common tests required are dental check-up, routine blood test, CT or MRI scan, neurological examination, electromyography, nerve conduction velocity test, etc.
Differential diagnosis – Since many other complaints can mimic symptoms or pain of trigeminal neuralgia, it is better to rule out those things before proceeding to the treatment for trigeminal neuralgia. The most important factors to rule out are dental problems, headache or migraine or sinusitis, jaw pain or temporam and ibular joint pain, brain tumours, etc. Commonly triggers give a hint at trigeminal neuralgia. Trigeminal neuralgia by no means wakes one from sleep; likewise its pain will not get better with massage or hot fomentation as in others.
Prevention and management
Avoid
  • Stress and tension
  • Triggers
  • Direct air flow in face while travelling or sleeping
  • Avoid cold exposures or temperatures and cold bath
  • Massaging violently with analgesics, since it often aggravates the complaints
General treatment – In general, treatment will always be individualized, according to the origin and cause of disease or complaints. Unless otherwise the cause is found out, treatment with any system becomes complicated and the result will not be satisfactory. But most often the ultimate cause for trigeminal neuralgic cannot be found. So, most of the patients will be treated only on the basis of symptoms.
After ruling out all differential diagnosis (dental pain, migraine, sinusitis, etc.) treatment for trigeminal neuralgia will be initially treated with a course of anti-inflammatory drugs and pain-killers. In addition, analgesic gels and supplements like calcium, magnesium and essential fatty acids will be provided.
Then, according to the improvement or presentation of complaints, further course of treatment will be planned. In extreme and intolerable cases, seizure medicines or steroidal preparations with anti-depressants or sleeping pills will be prescribed to manage the excruciating pain at the earliest. Most of the people would respond well with seizuremedicines but no one can deny their side-
effects of drowsiness, fatigue, lack of concentration, nausea, etc. Also, often trigeminal neuralgia will go for a remission period after treatment. Here, one should not feel happy taking reduction / absence of pain as cure and should not quit treatment immediately, since trigeminal neuralgia can rebound strongly at any time or shortly after stoppage of medicines or even while on medication.
Some doctors would give a try with steroidal or alcohol or phenol injections, short wave diathermy, electric current, radiation, etc., for managing pain. Here also, relief will be short-lived. As a last resort, neurosurgery will be opted for surgical dissection of nerve to root out all the pain. This is the best method for those who wish to avoid medication for years and to stay away from the side-effects of drugs. But the reward of successful surgery is numbness of the face.
Homeopathic approach 

Even though modern system of medicine claims that trigeminal neuralgia cannot be cured altogether with medicines and can only be maintained with anti-convulsants or pain-killers, Homeopathy can provide very good relief from this terrible nervous pain even to near normal without any side-effects. It is always wise to treat the condition than to suppress it with pain-killers or anti-convulsants. Also one should be aware that with suppressants, the situation will often get worse with time, leading to disappointment, since here pleasure of relief is nothing else but the intermission of complaint.
Normally, fear of dependency of drugs and long-term medication and their side-effects bring sufferers to Homeopathy. Homeopathy can really do wonders for these patients. Homeopathy medicines act not on the superficial plane but deeply to root out the complaints. So it may need some time to show response or result. Patients may need patience and tolerance (more of this needed) to enjoy its results.
To have good response, it is first the duty of the physician to educate the sufferer about the disease, need for good rest, sleep and diet. Also it is essential to educate them to have precaution against cold, cough, flu, respiratory infections with hygienic measures since they all can bring flare-ups in the middle of treatment.
In Homeopathy, the response will be quick and good in persons who opt for Homeopathy treatment at the beginning of the condition and the response will be slow in persons who came for Homeopathy treatment later with dependence on Allopathic drugs. People depending on Allopathic drugs should not stop them all of a sudden, since if they to do so, they would often meet with a crescendo of rebounding pain. So, Allopathic medicines / anti-seizure medicines used for suppressing pain of trigeminal neuralgia should be tapered slowly after feeling betterment with homeopathic medicines. i.e. first, they should increase the duration between medications, then they should reduce the dosage levels slowly to get it stopped. Here one need not bother about using two systems of medicines simultaneously, since there won’t be any side-effects or interactions.
With respect to disease or complaints, patients’ feelings may differ. Homeopathy stands here with individualisation. Some patients may feel better with support, some others will get startled by even a touch and for some others, touch aggravates but pressure ameliorates. These modalities will be given much importance in Homeopathy for selection of medicine. By giving importance to the feelings / sensations, aggravating factors, constitution of the patient with detailed case taking, Homeopathy can provide miraculous relief from this nervous pain without any side-effects.
Homeopathic medicines commonly used in cases of trigeminal neuralgia are Aconite, Arg nit, Ars alb, Aurum met, Belladonna, Bryonia, Calc phos, Causticum, Chamomilla, Colocynthis, Hypericum, Kali bich, Kali phos, Lachesis, Lycopodium, Mag carb, Mag phos, Mezereum, Natrum mur, Nux vom, Phytolacco, Plumbum met, Pulsatilla, Rhus tox, Ruta, Sangunaria, Spigelia, Strychinum, Tarentula, Valeriana, Zinc met, etc, These Medicines should be taken under the advice and diagnosis of a qualified Homeopath.

for new hope

Dr. S. Chidambaranathan, BHMS, MD (Homeo)
Laxmi Homeo Clinic
24 E. New Mahalipatti Road
Madurai, TN 625 001
India

Tel:  +91-452-233-8833 | +91-984-319-1011 (Mob)
Fax: +91-452-233-0196
E-mail:  drcheena@yahoo.com

(Disclaimer - The contents of this column are for informational purpose only. The content is not intended to be a substitute for professional healthcare advice, diagnosis, or treatment. Always seek the advice of healthcare professional for any health problem or medical condition.)

Dr Cheena

Dr Cheena

Simple notes on Drcheena

Dr S. Chidambaranathan is a compassionate and highly skilled homeopathic doctor who has been rated as the Best Homoeopathic Doctor in Madurai.

Because of him “LAXMI HOMOEO CLINIC” is a “Healing Gateway” Imparting quality treatment to his patients with dignity and utmost care.

He is always reachable and concerned for comfort of the sick to cope up with their expectation. Because of his treatment with highest standard many patients were able to avoid surgeries in many incidences. In LAXMI HOMOEO CLINIC patients are treated with dignity, kindness and respect with privacy.

Further Dr S. Chidambaranathan helps the patients to manage their health on their own and to stay independent from all sorts of medicines as much as possible.

To cope up with ever changing trends in medicine and disease management he continues to upgrade his knowledge evident by the various papers presented
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