Don't Assume

General General TN & GPN (Old Site)
1

You know what they say about assume. "It makes an XXXX of u and me" We learned a lesson two weeks ago that hopefully no one else will ever have to repeat.

My Granddaughter (like me) has TN pain as the result of secondary Sjogrens and psoriatic arthritis. her pain flares as her disease changes. Several weeks ago, She woke up with severe pain. We started the regime we follow when stuff flares. Heat /ice steroids increased NSAIDs etc. By mid day NOTHING was working so we went to step 2 - analgesia still no change I called the doc who saw her the next afternoon. She was miserable beyond anything she had ever experienced.

To make a long story short, her TN pain had NOTHING to do with TN. It turns out she had 4 impacted and infected wisdom teeth. The oral surgeon (also an ENT) admitted her and did the extractions in the OR under General anesthetic to make sure he didn't impact anything to make things worse. (He understands the effect of dental work on TN patients)

So here is my message. When things are different DON'T cowboy up. We are as susceptible (if not more so) to things other than TN causing problems. Call and get it checked out. Beats 3 days in the hospital on IV antibiotics and Morphine drip.

2

I'm glad your grand daughter is feeling better. Many folk seem to be pigeon holed, fortunately your grand daughter wasn't one.

Kind of disagree her pain was nothing to do with TN, and in writing this reading your past posts and indeed this one suggests it was but wasn't, in the sense many things cause TN like pain. I'm not preaching, you demonstrate you know more than most neuros/ medics etc. Either way it was pain in the trigeminal distribution, trigeminal neuralgia, not a diagnosis but pain in the distribution of said nerve innervation. I think I take your point which might be the above intention but obviously willing to stand corrected.

Regardless of the cause of TN, the common denominator is inflammation. I don't know your grand daughter's teeth problems, but aren't most caused by meds and/or diet (as an aside I've three shocking teeth, which I know for my own general health I should address, but in the main cause no pain unless I catch a cold or similar, in part due to the dirty habit of smoking)

Autoimmune disease ( any number of 120+) is an inflammatory reaction, the bodies way of attempting to heal, if we give it the right tools we aid it, without said individual is stuck in the inflammatory cycle, and consequently pain. Generally drugs are destructive, off the top of my head I can't think of one that cures anything, as opposed to treating symptoms.

Regardless of the cause of TN like pain, who in the medical world advises changes in diet, to address inflammation. Your neuro doesn't, your surgeon doesn't- they have pills a needle or a knife. We know the neck/ autoimmune causes TN pain, but once we reach the previously mentioned does anyone get referred back down the tree, it would be the exception if it ever happens.

Even if your TN is caused by vascular TN root compression (personnel note; It is unlikely- if not incredible, or IF it is without systemic inflammation, vascular compression wouldn't be a problem. Reference to people with vascular compression and no TN.)

Stick my neck out, I shouldn't it could cause TN, we should be addressing systemic inflammation in the individual, regardless of the cause be it vascular, cervical, autoimmune or other, before destructive/ pharma symptomatic solutions, which likely are short term at best.

3

How long has she had this TN pain for, and was it type I electric shocks?

I'm curious how did you conclude that the TN pain has nothing to do with TN? And how was it established that impacted wisdom teeth were the cause of the pain? I am assuming that after extractions the pain immediately disappeared?

This makes me curious because I also have all my wisdom teeth still in, and it was recommended that I get them extracted. However, I am unsure how to establish this causality (wisdom teeth causing TN pain) like you did.

4

The assumption was that this was a pain episode from the TN, it wasn't. She still has TN and sjogrens (Crohns, EDS, and her TBI) even after the surgery. Spitting pus was a pretty big clue. She had a "flare" for a week or more

The point was this could have been a lot worse if the pain was simply written off to TN. It was bad enough as it was. There are no simplistic solutions. Not for Tana anyway.

5

So ... I pick up from this discussion that a problem elsewhere in the body (such as a cold, sinus infection, bronchitis, dental issues -- need for wisdom teeth extraction, root canal, or even the filling of a simple cavity, or cervical disc issues) can trigger TN attacks. Yep -- probably so, based on my own experiences. Simply yet directly stated here.

6

This is one reason I find TN so difficult to live with. It mimics so many other things that there is always room for doubt during a flare up, especially when faced with a brand new symptom.

7

Exactly!!! That's why we don't want to assume that new TN like symptom is TN. It can be disaster if we do

justjane37 said:

This is one reason I find TN so difficult to live with. It mimics so many other things that there is always room for doubt during a flare up, especially when faced with a brand new symptom.