Does anyone here suffer with migraines along with the tn, as well?
I've had both "common" and, less frequently, "classic" migraines at least since my Atypical Trigeminal Neuralgia began in 1972. It's possible that I had the migraine headaches even before this, but I do not recall specifically.
I'm at least 50% confident that I suffered both "Trauma-Induced" Migraine and probably ATN from two years of playing football when I was a teenager. I hardly ever get both a migraine and an episode of nerve pain simultaneously, but I do regularly have each of these conditions occur as a sort of "continuum" where I will get a very bad migraine that lasts from six- to thirty-six hours, and this will "transform" itself into my severe, episodic right mandibular nerve pain.
But I usually get the episodic nerve pain or ATN "on its own" and without the previous migraine associated with it, I would say about 80% of the time. But that other 20% is really difficult, because when the migraine shifts into the nerve pain, much of the medications and treatments for the former condition are not only different that those used for the latter, but they are even contra-indicated. It's very well known that morphine, for instance, is not of any benefit for most kinds of migraines, but my ATN or nerve pain is very responsive to many opioid medications.
I just updated the ATN wiki today slightly to say that while ATN is often mistaken as migraine headache, that migraines can ALSO be present along-side ATN. I hope it doesn't get edited out, because this has been my "life" for nearly the past forty years. I wish you well! Carry On! (jqt)
I've seen many reports of frequent migraines among this population. I don't think the two disorders are strictly "co-morbid" -- as in occurring together often enough to be considered strongly associated or linked. But yes, they can occur together. You'll likely need to be treated individually for each one, as the meds used in Migraine are generally not effective against TN.
Yes both before the ATN and now during the ATN. Peace, Min
The fact that quite a few patients who are diagnosed with TN and especially those diagnosed with ATN also have migraines does seem to "point" to some kind of correlation, maybe the Trigeminal Nerve and all of its mysterious 'feedback loops' are much more complicated than is currently understood.
The problem in management of these is if the Treating Physician diagnoses migraine and then STOPS right there. Since the early 1990s, the -triptan medications have been a real godsend, but NONE (or very few) of the regimens for migraine are of any help for the severe pain of either TN or especially ATN.
I can have a severe episode of nerve pain that is always localized in the R mandibular region in the morning, and I know that opiates are quite helpful and offer significant relief, and I would say that these are life-saving. The ATN is extremely responsive to morphine and other natural opiates, as well as some (but not all!) opioid (synthetic) medications. But then by evening, I am often 'transformed' into having a full-blown "classic" migraine headache, and that IS NOT responsive at all to opiates, which are then quite useless for anything except maybe very minor relief, to the point where these are really contra-indicated.
In four decades, I've learned quite a bit about these illnesses and the way they manifest themselves in my own case, but I also know that every patient with TN and especially ATN has highly individualized symptoms, and what works for one patient is not always (or even rarely) good for other patients.
The fact that I sometimes do experience both of these often devastating illnesses (Atypical Trigeminal Neuralgia and Migraine Headaches) in a continuum, with the migraine almost always occurring LAST, to me seems very revealing of something in the way the "Spreading Depression Theory" of migraine has been examined. (Note that the term "depression" here is not being used in its usual sense, although a kind of pseudo-Clinical Depression is definitely something that does seem to result from the chronic nature and frequency of the pain.)
I am not surprised to hear many ATN patients, even those who never have reported having a "headache," also report that their ATN pain does seem to have a multi-faceted character, where symptoms during an attack can almost change like the colors of a rainbow, especially if the attack lasts more than twenty-four hours. My guess (and it's only that, a guess) is that migraines could either be part of this larger "constellation" of symptoms of something wrong with the Trigeminal Nerve, or perhaps ATN is part of a larger continuum of migraine symptoms, or that these could be "opposite ends" of the same or similar disease or illness.
It's very complex, and I cannot say for certain that these illnesses (migraine and TN/ATN) are definitively part of the same illness, and it's possible that some of us, myself included, are just unlucky enough to have BOTH. But I'd be very surprised if one day, research doesn't find a strong link between these two conditions. Meanwhile, I Carry On! (jqt)
Yes - my migraines are fierce, often worse than the TN. It took a while but I finally found a some effective meds for both TN and the migraines. Like others that replied I am also Atypical.
A few things will trigger a migraine including not taking my pills at the correct time of day, a restless sleep, change in season, and I usually get a real good one anywhere from 2 days to 6 hours before a big attack. Getting the migraines before a big attack - I didn't associate the two together until these last few months.
If you are getting them and not taking any meds for them - talk to your Doctor. There are options out there to treat both problems together.
Elaine
Ok …So If we know Migraines are caused by constrictions of the blood vessels. Then could we say that after so many episodes of migraines over times the constricting somehow causes the blood vessels to then move OUT of alignment thereby causing them to come to rest on a certain nerve we’ve all come to know so well. ??
The dilation of blood vessels was an extremely popular theory of migraine for many decades, but it has been displaced by much newer, and probably more accurate theories about a spreading neurological “storm” in the brain, specifically in the base of the brain or brain stem. The behavior of blood vessels during a migraine “attack” is more likely a result of those neurological changes, and therefore probably not a cause of the illness. The understanding of migraine headache has been revolutionized since the introduction of the -triptan medications in the early 1990s, which began with Imitrex (sumatriptan). It still seems recent to me, but this drug has been available for so long now, it has been “off-patent” for quite some time. The one that works best for me is rizatriptan or Maxalt, and I am waiting eagerly for it to also go off-patent, since it retails at over $15 per dose, with no generic, at least in this country. And if you try to order them (generic) online, there’s virtually no way to tell if they are real. But many patients do resort to this, because quite a few insurance companies have enacted deductibles that exceed $50 per refill!
Min C said:
Ok ...So If we know Migraines are caused by constrictions of the blood vessels. Then could we say that after so many episodes of migraines over times the constricting somehow causes the blood vessels to then move OUT of alignment thereby causing them to come to rest on a certain nerve we've all come to know so well. ??
I could see how that might work. When you are very hot outside putting cold water on your head is a good way to cool you down and also keeps me from passing out! HAHA
And John,...Someone needs to turn off the "STORM" . I for one, am done with it!
COLD treatments have been known and used for probably centuries, and the present day knowledge is to especially try ALTERNATING COLD and HOT. A frozen bag of peas works wonders for the former, and a wet towel placed in the microwave is sometimes magical the way it can give at least temporary relief.
Since quite a few people here do seem to have Migraines, I thought it might be good to list out the various '-triptan' medications, by generic name, as well as Brand Name, since to my knowledge, the only -triptan to come off-patent in the U.S.A. so far is Imitrex (sumatriptan).
Althabetically, we have: almotriptan (Axert), aratriptan (Amerge), eletriptan (Relpax), frovatriptan (Frova), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig). They probably have invented a few others, as well as some combinations of these with other drugs, so use this as a guide to get started.
Some of these work on slightly different SEROTONIN receptors 5HT1 and 5HT2 and without getting too technical, the fact is is that one drug may not work well at all for you, while another may work wonders!
These all come in pill form, however I believe it's still possible to get Imitrex (and maybe others?) as an injectible.
If you do have migraines, and have not even tried any of these, please ask your physician for SAMPLES, and give these a good chance to work. It took me about three years to discover that sumatriptan did indeed have an effect on some of my headaches.
Ultimately I switched to rizatriptan (Maxalt), and when it works, it's almost a miracle the way it can often obliterate a full-blown headache, with very few side-effects (other than making your wallet much lighter). Carry On! (jqt)
Thanks all for your suggestions and input. This is the first experience I have had with migraines. I tried ice packs and the do give some relief. I tried the Maxalt. It gave me no relief. I was hospitalized a few days and treated with DHE. That lasted as long as I was in the hospital and the IV was going. After I was home the next day the headaches were back.
I am in pain so frequently and the pain has variated so I can't tell which pain is which. My neurologist has decided these this pain is migraines because I had an MRI and he saw two spots on my brain. He explained that these spots are indicative of either MS or migraines. He really believes it's migraines and MS, so that's what he is trying to treat now. The TN and the migraines.
However, I continue to pray and stay hopeful knowing that the day will come when I will get back to normal.
Hope you feel better soon Aleida. Hugs, Min
Did your physician tell you of what nature those "spots" are? And where they are? MS is most often attributed to a demyelinating disorder in which the surfaces of nerves develop plaques. Was your doctor suggesting plaques or something else?
This is the first time I've heard of migraines being attributed to "spots" on the brain. The following link from Mayo offers an overview on causative factors in Migraine. There is clearly still a lot to be learned by science on this subject: http://www.mayoclinic.com/health/migraine-headache/DS00120/DSECTION=causes
Obviously, Migraine can be co-morbid (occur at the same time) with other neurological problems, of which MS is one.
Regards, Red
I’ve had migraines since I was a toddler so I can manage them pretty well. They come once a month, usually. However, I had them every day leading in to my 8 month diagnosis of TN, but they have gone back to normal since then. Thankfully! They truely suck.
He (my doctor) showed me the picture of my MRI and the difference between mine and patient that would be diagnosed with MS. The spots on my brain were small pinpoint size dots and compare to the size of the MS diagnosed patience which was larger. However, he did say that he would like to do another MRI in a couple months to see if there are more spots that have appeared.
Richard A. “Red” Lawhern said:
Did your physician tell you of what nature those "spots" are? And where they are? MS is most often attributed to a demyelinating disorder in which the surfaces of nerves develop plaques. Was your doctor suggesting plaques or something else?
This is the first time I've heard of migraines being attributed to "spots" on the brain. The following link from Mayo offers an overview on causative factors in Migraine. There is clearly still a lot to be learned by science on this subject: http://www.mayoclinic.com/health/migraine-headache/DS00120/DSECTION...
Obviously, Migraine can be co-morbid (occur at the same time) with other neurological problems, of which MS is one.
Regards, Red
You might ask your doctor how he would differentially diagnose MS plaques versus widely distributed calcium deposits. Both can occur (rarely together at one time), and treatment for the two is somewhat different. When the next MRI procedure is done, you will also want to inquire concerning the resolution it is set up for. Maximum res both with and without contrast agent is generally considered best practice. Max res should be on the order of 0.7 mm.
Regards, Red