Trigeminal Neuralgia vs. Neuropathy
 

Hi, everyone! I thought I'd jump on here and intoduce myself. I was DXed last week with Trigeminal Sensory Neuropathy. Does anyone know anything about this? I've done some google searches but most of the information is old research studies or directs me to TN websites. Are these the same conditions? If not, how does it differ than TN? Thanks for any information you can provide! Karate Mom

Any damage to a nerve may be called neuropathy.
Neuropathy means disease of nerves.


Neuralgia is when a nerve sends pain signals uncontrollably.

Some medical terms overlap each other.

Trigeminal neuralgia may involve a compression, injury or chemical damage to the trigeminal nerve, causing the "neuralgia" (pain sensations).

Thanks, Mrs. D! That clarifies things for me. Can you tell me what types of chemicals could cause damage to a facial nerve? Thanks!

Injections from the dentist come to mind.

Some drugs damage nerves.... Cipro, Avelox, Levaquin, Flagyl.

There is some evidence that inhaled Flumist vaccine can cause Bell's palsy and TN.

Sometimes infections in nerve roots of teeth, or in the cavernous sinus can give TN like pain.

This is what the cavernous sinus is:
http://en.wikipedia.org/wiki/Cavernous_sinus

I have trigeminal neuropathy
 

It overlaps a bit, from my understanding. I had both Type 1 and Type 2. Here is a paper that defines them the best, by a leader in the field.
http://thejns.org/doi/pdf/10.3171/foc.2005.18.5.4
These are the classifications that are used by the Trigeminal Neuralgia Association as well as the leading book in this field, "Striking Back..."
I eventually had MVD surgery, which took care of the Type 1, but the Type 2remained. I believe that somewhere in that paper they say that Type 2 is a result of prolonged Type 1. In addition to blood vessels compressing my nerve, I have significant cranial arachnoiditis, or scarring of the arachnoid layer, which was wrapped tightly around the nerve.
It seems that the different types are classified by the symptoms and the causes.
My doctors are not thoroughly up to speed on these classifications (they are a bit "old school", although my neurosurgeon knows of the Type 1 Type 2 definitions), so they have called it Trigeminal Neuralgia; Trigeminal Neuropathy; TN Type 2; and Atypical Facial Pain, all through my medical records. Confusing, right?
I have not heard the term "Sensory" included in the diagnosis before. Can you explain what it feels like to you?
I hope that I am not being too confusing, but the paper named above should help.
Welcome,
Lily

Mrs. D - Thank you for the information. It was very interesting. I didn't realize that dental injections could cause this type of thing. Scary thought. I don't believe that my condition was caused by dental injections, though. I think I sustained systemic nerve damage from a toxin. I've also been lurking on the PN board and you seem to be a wealth of knowledge! You must be a doctor or a patient who has done a ton of research! :) I hope to learn a thing or two from you! :)

Lily - Thank you so much for the welcome and the link. It was very informative and helpful and helped clarify things a bit. The terminology can be confusing. It sounds like your records contain all of the terms, so you must really be confused. I would be! Of course, I'm new to all of this, so I'm still in the early stages of the learning process.

You asked what it feels like to me. The sensory symptoms are constant, painful and unrelenting. I have facial (along the trigeminal nerve) and teeth tingling/buzzing, pain and numbness, which drives me crazy. I also have the tingling in my arms, hands, legs and feet, but the facial sensations are the ones that get on my nerves the most. I have horrible ear pain (ENT cleared all ear issues) and jaw pain. My teeth throb, ache, tingle, buzz, hurt and it is constant, though the intensity can vary from bad to severely agonizing. A routine dental cleaning last fall set the symptoms into high gear and it took many weeks for them to return to their "normal." I probably left something out, but this is what I can recall at the moment. I have all of these symptoms on both sides of my face, though the left side is worse than the right. I hope that helps answer your question. Does it differ than your symptoms in any way? Are you on any meds? I wish everyone a reduced pain or pain free day!

Karate Mom

Dear KM,
You know, I really don't worry too much about what they call it, as long as they are taking the right treament path. I have studied this condition backwards and forwards, so I've learned what all of my treatment options are. I sure wish that there were more. The only one that was new and a surprise to me was the one where they use one of those spinal pumps to deliver a snail venom directly into the CSF. Possible side effect: Psychosis. :eek:
I am so sorry to hear what you are suffering through. I have that unrelelting pain as well (I think that that is probably why they are calling it a neuropathy instead of a neuralgia, in your case). It can be torturous. I know. I have it on the upper two nerve paths, and I thought is was bad enough, but now the teeth and upper palate are starting to chime in, and it is a whole new level. I cannot stand to get my teeth cleaned - the last time landed me in the ER for Dilaudid shots. In my opinion, and this is only in my personal experience, I think that the TN2 is worse that the TN1. I had TN1, but at least it would let up after a minute or so. This constant pain is often crippling. I find it to be innapropriate for the articles and published info to state that it is somehow less.
This is what I take: Anti-seizures: Neurontin, Trileptal, Lamictal. Antidepressants: Nortriptyline. Pain Meds: Dilaudid. Muscle relaxants: Valium. I think that's all of them.
I hope that you are able to find relief in some manner - that you have the neuropathies elsewhere must be difficult. I wish you a pain free or reduced -pain day as well. Thank you for sharing your story.
Lily

I have TN
 

I am a newbie! In November 2010 I was diagnosed with Trigeminal Neuralgia, meds did not work to stop the attacks so in February 2011 I had MVD surgery. My surgery was 6 hours long followed by 2 days in ICU and 2 days in a regular hospital room. I immediatley suffered from numbness on the right side of my face from just below my nose to my jaw including half my mouth and tongue. And just in front of my right ear. I also have severe itching and tingleing and still have small attacks which are more annoying than painful. My docs say this is normal for awhile after MVD but is has been 3 months. More recently I have pain when any pressure is put on the sight of my incision is this all really normal? Any thoughts?

After being diagnosed with TN and taking Tegretol for a year, I stopped the drug due to side effects and went to another neurologist who thinks I may have Tri Neuropathy because my symptoms are mild...just occassional tingling and some sharp pains anywhere on my face. I have had this for about 7 yrs. and I do not take any meds....it is tolerable to live with if it does not get worse.

Mtgirl

neuralgia vs neuropathy
 

I thought neuropathy implied the death of the nerve??

OK,, I may be on my horse again but have you looked into a PNS system,,will that work?
Even if the nerve is compromised in some fashion it is still creating pain,,wouldn't a PNS system still be a possibility for relief??

Mrs.D,,if you are still in this thread, what is your opinion??
If you think it is a possible,, last nerve or anyone,,feel free to contact me about the procedure or with questions,,Beth