In one of your links, I found a definition of Type II, or ATN which was classified as ATFP. Often ATFP is not taken seriously by physicians. It is definitions like this that make me go GRRRRRRRR (and I assure you that is a very non-intimidating sound coming from me, but still).
Below describes, what many informed physicians now know is Atypical Trigeminal Neuralgia (actually it seems to be the prevalent type on this site). It has these symptoms, mostly. It doesn't respond well to surgery, typically. The same medicines don't seem to help with it, as do with Type I.
If they are both disorders of the 5th cranial nerve, and the path of pain is that of the 5th cranial nerve, then why would it be called "Atypical Facial Pain", anywhere? I have to, with all due respect for people with degrees in medicine who agree with this diagnosis, disagree with it.
The following description of ATN seems dangerously ignorant to me, but that's just me:
"Atypical Facial Pain
Atypical facial pain (or idiopathic facial pain) is characterized by deep, achy, constant, pulling or crushing pain that involves diffuse areas of the face and head. The pain fluctuates in intensity and severity. Trigger points on the face cannot be found, the pain is often worse at night, and may be aggravated by activity.
In the majority of cases, only one side of the face is affected, but pain on both sides is also possible. The symptoms may initially appear similar to trigeminal neuralgia, although progress to an atypical facial pain pattern. The diagnosis is made when the origin of pain is undetermined or when symptoms do not correlate with any other facial pain syndrome. Atypical facial pain affects more woman than men, and is often accompanied by depression. However, this disorder is not of psychogenic origin.
Treatments: Unfortunately, atypical facial pain is typically difficult to treat, and surgery is generally avoided. While radiofrequency rhizotomy has been performed, such destructive interventions may actually worsen the pain. Tricyclic antidepressant medications can provide sufferers with modest relief of their symptoms. Conventional analgesic drugs, including opioids, can also be effective in selected individuals, often under the direction of a comprehensive pain management program."
*This diagnosis of ATFP is one that you find repetitively in journals of medicine. THIS DIAGNOSIS SUMMARY OF ATYPICAL FACIAL PAIN DESCRIBES ATN, or TYPE II TRIGEMINAL NEURALGIA. I do not understand why, if the path of pain follows the path of the 5th cranial nerve, why this has not been updated yet.
I spoke with a physician, at one point, in my treatment who said that medical awareness of "Atypical Trigeminal Neuralgia", or Type II, was still being categorized as ATFP, due to yes, lack of research and awareness that the classification had been updated.
It is classifications like this one that make me a bit jittery about whether or not they understand that the pain comes from the same origin as TN, but presents with different symptoms.
If is not really that difficult to treat the symptoms of ATN in a lot of patients. Doctors are simply hesitant to do it, because, in many cases, even though the symptoms present as a problem with the Trigeminal Nerve, it remains, in many, an invisible illness. As we know, many times, the source of compression, or the compromised myelin sheath cannot be found with the diagnostics typically currently run.
I think what has been demonstrated here by all of these different links, is that there is no gold standard of definition of this disorder. They are still "all over the board with this one".
Yes, it can have many different causes, but ATN is characterized again and again by throbbing, crushing, burning and typically constant pain, without remission. It wrecks lives.
I was one of the blessed ones who fought until my pain was no longer dismissed, and I feel, finally, close to adequately treated.
I just want that for other ATN patients, and the fact that there is so much controversy surrounding the validity and the origin of this illness, yes, hope must float and float!!!! (and what is tortured suffering, as I see it, will continue to prevail amongst the ranks of those with Type II, or ATN).
That's my opinion, and my opinion, is that it is the best link I have found so far and that I would like to see that Neuro!
I believe my OHSU's classification system hits the core of Type II right on the nose!!! I was so happy to see it so accurately described.
TN and ATN patients may all have different "causes" for their symptoms, but the symptoms are different. Therefore, the treatments are different. What works for Type I has a much lower success rate for Type II. That is all I am trying to make anyone understand.
I am not out to be a "know it all", or act like I am an expert. I'm not. But, I've seen and heard enough here, on this site alone to know that there are clearly, two types of true TN pain, mainly. One has options, the other is a very, very misunderstood illness, and is, in most cases, extremely poorly managed.
I just want doctor's to be more compassionate, and understanding of these patients who suffer all of the time, with something that, if diagnosed correctly and treated correctly, can be helped. I have links which tell how this may be done. I am just too tired to post them right now, but I will be re-visiting this Discussion.
Thanks all, and best wishes for compassionate and informed care.
Your friend,
Stef
Bob Snodgrass said:
"The presumed cause..."
http://www.ninds.nih.gov/disorders/trigeminal_neuralgia/detail_trig...
"Several theories exist..."
http://en.wikipedia.org/wiki/Trigeminal_neuralgia#Cause
"In all cases, though...
"http://www.emedicinehealth.com/trigeminal_neuralgia_facial_nerve_pa...
"a well known clinical entity..."
http://www.ncbi.nlm.nih.gov/pubmed/19487899 ----- The (((condition))) has no clear-cut cause.
Everyone will have different opinions, as when you Google - {trigeminal neuralgia causes}, you get 310,000 results.
However, and with further discussion;) A. M. Kaufmann & M. Patel Centre for Cranial Nerve Disorders at the University of Manitoba, Canada define seven (7) forms of TN: typical TN, atypical TN, pre-TN, multiple-sclerosis-related TN, secondary TN, post-traumatic TN (trigeminal neuropathy), and failed TN.
Stating these forms of TN should be distinguished from idiopathic (atypical) facial pain, as well as other disorders causing cranio-facial pain.
(((Stef))), I just have more links, adding: "Peer assessment of journal quality in clinical neurology"
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773051/
I enjoy "Neurology Now" - "Neurology Then":P)! Their TN section has 26 results, ranging from 09/2007 - 04/2010:
http://journals.lww.com/neurologynow/pages/results.aspx?k=trigemina...
Hospitals seem to offer, (with a hint of sarcasm) the "same fare" in treatment(s), due to the lack of clinical trials and research dollars...in my humbling experiences, and observation.
Sadly, this could become a New York Knicks discussion. Hope floats! bob