Robert A. Mericle, M.D - How do you know if you have trigeminal neuralgia?
	K. Singh Sahni, M.D., F.A.C.S. - Is it really classic trigeminal neuralgia? One neurosurgeon's perspective
	Robert A. Mericle, M.D - What can cause trigeminal neuralgia?
	Mark E. Linskey, M.D. - Kids & trigeminal neuralgia
	Mark E. Linskey, M.D. - Trigeminal neuralgia is a progressive syndrome

TRIGEMINAL NEURALGIA

Trigeminal neuralgia is also known as “tic douloureux”.  It begins with sudden severe electric shock like pain usually just on one side of the face lasting a few seconds to a few minutes.  It is often triggered by some specific action such as talking, chewing, touching, or shaving.  Trigeminal neuralgia may or may not have a trigger point on the face whereby touching it aggravates the pain.  It has periods of remission lasting days, weeks, months or even years.

The two trigeminal nerves are the fifth set of cranial nerves.  They provide facial sensations and control most of the chewing muscles.  The right trigeminal nerve serves the right side of the face.  The left trigeminal nerve serves the left side of the face.  Each nerve has three branches:  ophthalmic (V1), maxillary (V2), and mandibular (V3).  Pain can occur in one, two, or all three branches.

Often, over time, trigeminal neuralgia patients pain description changes to electric shock pain followed by lengthening periods of dull, achy, and/or burning pain.  Usually, the periods of pain grow longer and the periods of remission get shorter.  Eventually, many patients report the pain to be constant with only a rare shock which is known as Trigeminal Neuropathic pain.

There is no cure for trigeminal neuralgia.  Many health care providers believe trigeminal neuralgia is caused by a blood vessel(s) compressing the trigeminal nerve as it exits the brainstem.

According to the National Human Genome Research Institute, the exact role of heredity regarding trigeminal neuralgia remains unclear. However, estimates suggest that roughly five percent of trigeminal neuralgia patients have a history of other family members who have had the disorder. Familial trigeminal neuralgia has been noted to be more common in women, mostly in women older than 50 years. This has led to speculation that there is a dominant pattern of genetic transfer.

Collected Resources:  Trigeminal neuralgia
http://www.neurology.org/cgi/collection/trigeminal_neuralgia

Diagnostic accuracy of trigeminal reflex testing in trigeminal neuralgia
http://www.neurology.org/cgi/content/abstract/66/1/139

From paroxysmal to chronic pain in trigeminal neuralgia: Implications of central sensitization
http://www.mdconsult.com/das/article/body/102623995-2/jorg=journal&source=&sp=19940304&sid=0/N/606760/1.html?issn=

Historical perspectives on the diagnosis and treatment of trigeminal neuralgia
http://thejns.org/doi/pdf/10.3171/foc.2005.18.5.5

Impaired trigeminal nociceptive processing in patients with trigeminal neuralgia
http://www.neurology.org/cgi/content/abstract/69/9/835

NINDS Trigeminal Neuralgia Information Page

Non-antiepileptic drugs for trigeminal neuralgia
http://www.cochrane.org/reviews/en/ab004029.html

Pain Management:  Facial Pain
http://www.webmd.com/pain-management/guide/trigeminal-neuralgia

Role of patient history and physical examination in the diagnosis of trigeminal neuralgia
http://thejns.org/doi/pdf/10.3171/foc.2005.18.5.2

Role of the neurologist in the evaluation and treatment of patients with trigeminal neuralgia
http://thejns.org/doi/pdf/10.3171/foc.2005.18.5.3

Subcutaneous Sumatriptan for Refractory Trigeminal Neuralgia: Results from a Double-Blind Placebo Controlled Crossover Trial http://www.asaabstracts.com/strands/asaabstracts/abstract.htm

Treatment of atypical trigeminal neuralgia with microvascular decompression
http://www.neurologyindia.com/article.asp?issn=0028-3886;year=2006;volume=54;issue=1;spage=53;epage=56;aulast=Hai

Trigeminal neuralgia - eMedicine
http://www.emedicine.com/emerg/TOPIC617.HTM

Trigeminal neuralgia - Facial Neuralgia Resources
http://facial-neuralgia.org/conditions/tn.html

Trigeminal neuralgia - Mayo Clinic
http://www.mayoclinic.com/health/trigeminal-neuralgia/DS00446

Trigeminal Neuralgia - Merck Manual Professional
http://www.merck.com/mmpe/sec16/ch219/ch219g.html

Trigeminal Neuralgia - NeurosurgeryToday.org
http://www.neurosurgerytoday.org/what/patient_e/trigeminal.asp

Trigeminal neuralgia - Neurosurgical Focus
http://thejns.org/doi/pdf/10.3171/foc.2005.18.5.1

Trigeminal Neuralgia - Patient UK
http://www.patient.co.uk/showdoc/40000729

Trigeminal Neuralgia - StopPain.org

Trigeminal Neuralgia (Facial Nerve Pain)

Trigeminal neuralgia: definition and classification
http://thejns.org/doi/pdf/10.3171/foc.2005.18.5.4

Trigeminal neuralgia-- Pathology and pathogenesis
http://brain.oxfordjournals.org/cgi/content/full/124/12/2347

Trigeminal neuralgia and its management
http://www.bmj.com/cgi/content/full/334/7586/201?ck=nck

Trigeminal Neuralgia and Nociceptive Impairments
http://neurology.jwatch.org/cgi/content/citation/2007/1127/2

Striking Back! The Trigeminal Neuralgia and Face Pain Handbook; George Weigel and Kenneth F. Casey, M. D.; Whitehall Publishing Company; Naples, FL; 2004

Insights: Facts and Stories behind Trigeminal Neuralgia; Joanna M. Zakrzewska, MD;
Whitehall Publishing Company; Naples, FL; 2006

Organizations

Trigeminal Neuralgia Association
http://www.fpa-support.org/
925 N.W. 56th Terrace, Suite C
Gainesville, FL  32605
Phone:  352-331-7009 or 800-923-3608