Warning: I am not a health professional. This narrative aims to share my experience in conquering TN. If you are experiencing symptoms of facial pain, please seek the expertise of a health professional.
Trigeminal Neuralgia (TN) is poorly understood by front line health professionals.  Knowledge is power and is THE best tool you got. Be proactive, resilient and educate yourself.
You will find you are not alone (:
Info & Tips
  • Trigeminal neuralgia is a debilitating disorder that results in episodes of intense, stabbing, electric shock pain, usually on one side of the face.
  • Trigeminal neuralgia (TN) , is considered by many medical experts to be among the most painful of conditions of mankind, and was once labeled the “suicide disease” because before of the significant numbers of people taking their own lives before effective treatments were discovered (ex: prescription of anticonvulsant in 1942, carmabezapine in 1962).
  • Early neurosurgeons (Cushing, Dandy, Gardner) introduced the idea that TN is caused by compression of the nerve via a blood vessel. It is now a widely proven and accepted theory.  Other causes of trigeminal neuralgia include multiple sclerosis, nerve damage caused by trauma and tumors, or demyelination of the nerve (wear of the protective nerve cover)(Source: TNAC)
  • Most patients with this type of neuralgia, wait months or years to have a diagnosis. Because the pain initially targets the teeth and jaws (mandibular and maxillary nerves), patients often end up in a dentist chair, asking for teeth to relieve pain.

– Tip: Ask for a second opinion before you get treated. I believed at first that I needed a root canal … I was lucky to have a good dentist …

  • Getting a diagnosis is difficult because it is essentially clinical meaning it is solely based on the patient’s history and the symptoms he describes. To this end, it is important to note and remember the context of the first appearances of your neuralgia.

– Info: Many physicians confirm the diagnosis of a trigeminal neuralgia by a favorable response of your pain to carbamazepine (Tegretol®).  Also keep in mind that it is possible to have trigeminal neuralgia without experiencing all the classic symptoms (eg, triggers).

– Tip: create yourself a journal.  

  • The trigeminal neuralgia, once developed, is likely to have an exacerbating course. This means that there may be temporary remissions, but over time, the pain will inevitably become resistant to medication.
  • The medical literature states that the vast majority of cases of trigeminal neuralgia (classic or atypical) are caused by an arterial or/and veinous loop that compresses the nerve.

– Info: A majority of neurovascular conflicts dont appear on MRI’s.  The main goal of MRI is to eliminate anatomical causes such as tumors or multiple sclerosis. A competent Neurosurgeon will not brush you off on a reason that you’re MRI is negative (explanation herewith by Dr Casey’s webinar, 01:25:17)

  • Vascular decompression is THE procedure that provides the greatest pain relief solution in the long term.

– Info: Some studies state that the longer this compression is, the more it damages the protective sheath of the nerve. Also that the earlier the surgery takes place in neuralgia, the more likely it is to succeed. 

– Info: Microvascular decompression is the most valuable and lasting non-destructive nerve solution. 


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