What Is Trigeminal Neuralgia?

Trigeminal neuralgia (tic douloureux) is a disorder of the fifth cranial (trigeminal) nerve that causes episodes of intense, stabbing, electric shock-like pain in the areas of the face where the branches of the nerve are distributed – lips, eyes, nose, scalp, forehead, upper jaw, and lower jaw.

Classic symptoms of Trigeminal Neuralgia include:

  • Pain is described as lancinating – (sharp)
  • Pain comes and goes (intermittent)
  • Pain must be in the distribution of the trigeminal nerve
  • There has to be triggers
  • There is remission
  • A diagnostic tool is the response to Tegretol (Carbamazepine)

Trigeminal nerve – (V) fifth cranial nerve V1: Ophtalmic-eye, forehead and nose.1-Sensory V2: Maxillary – upper teeth, gums and lip, the cheek, lower eyelid and the side of the nose.1-Sensory V3: Mandibular – lower teeth, lower gums and lower lip.

1. SENSORY: Transmits pressure, touch, pain and temperature signals to the brain.

2. MOTOR: Controls movement. Trigeminal Neuralgia pain can involve one or more branches of the trigeminal nerve.

A valuable clue to the diagnosis is the triggering of the pain with certain activities. Patients carefully avoid rubbing the face or shaving a trigger area.
Chewing, talking, smiling, or drinking cold or hot fluids may trigger Trigeminal Neuralgia pain. Touching, shaving, brushing teeth, blowing the nose, or cold/warm breeze also may bring on an attack.

From TNA Australia

Resolution of Trigeminal Neuralgia Following Chiropractic Care to Reduce Cervical Spine Vertebral Subluxations: A Case Study

Michael T. Burcon, B.Ph., D.C.1

Objective: This case study reports the improvement in quality of life experienced by a patient undergoing cervical specific care as an alternative to medication or surgery for the management of Trigeminal neuralgia.

C5. Diminished disc space and minor degenerative arthritis noted at C5/6 consistent with cervical trauma (whiplash).

Intervention and Outcomes: One week after specific adjustments to C5 and axis, TN pain diminished dramatically in frequency and intensity. After discussing the improvement with her neurologist, she started cutting back on her Gabapentin dosage. After eight weekly visits, the patient was completely off the medication and pain free. Additionally, she reduced her high blood pressure medication by fifty percent. After two years of monthly maintenance care, she is still pain free without medication, even after major dental work.

Clinical Features: A 57 year old female presented with right sided trigeminal neuralgia (TN) of two years duration. TN pain was helped by medication and exacerbated by exposure to cold. Secondary complaints included high blood pressure, hypothyroidism, diminished hearing in left ear, cervicalgia, bilateral shoulder pain, right shin numbness and allergies. Prescriptions include Gabapentin 900 mg 3xs/day (2700 total with 3600 being maximum prescribed), triamterene 37.5 mg 1x/day, synthroid 75 mg 1x/day and nasacort as needed. History included being knocked unconscious in a fall when ten years old, significant fall while skiing thirteen years prior and recent fall onto the sidewalk. Orthopedic and neurological examination demonstrated the right leg one inch short relative to the left leg, one inch bilateral cervical syndrome and positive modified Prill tests for atlas (C1), axis (C2) and C5. Cervical x-ray analysis determined listings of axis entire segment right and a posterior

Key Words: Trigeminal neuralgia, upper cervical subluxation complex, cervical specific adjustments, Gabapentin (Neurontin), cervical trauma, whiplash, chiropractic.

J. Vertebral Subluxation Res. October 26, 2009