Is the cause of type 2 normally trauma opposed to a compression? How many of us believe it was trauma dental or otherwise that caused type 2 and for how many of us did it come out of the blue?
I believe mine was caused by dental I had a root canal that failed and I ended up in the e.r.
Dental trauma I would say more but it would be lengthy and might involve some ugly language. I’m having a VERY bad day today and am bedridden
I am sorry to hear that Nomad... hang in there.. I wish you better days. Min
I have ATN and I just got both that and migraines on year on February 19th. We have no idea why, but life has changed from that date! The best guess is that I started Jenny Craig a month before and was eating all of their processed foods. If that is what started everything, somehow, the migraines would have triggered the TN. That isn't usually how it works, so it is unlikely. Unfortunately, we don't have many answers for our condition at all. Ugh.
No doubt in my mine it was dental related. I mean I had my teeth cleaned and bam I have tn type 2. Suffer everyday. Take nortriptyline and gabapentin. Also suffer from their side effects.
elstep said:
Is the cause of type 2 normally trauma opposed to a compression? How many of us believe it was trauma dental or otherwise that caused type 2 and for how many of us did it come out of the blue?
Did any of you that did a MRI have compressions?
I recommend a reading of our article "Who Gets Face Pain" under the Face Pain Info tab of our menu. A section of that article summarizes the experience of 650 or so of our members for whom the first medical professional seen was a dentist or endodontist.
Regards, Red
I had no pain whatsoever when I saw my dentist. An onlay fell off my tooth. She had a freakish time replacing it with a crown; it took three months. At one point she glued the crown on with permanent cement and it broke before I left the chair. She had me come in a few days later and it took her an hour to get it off. She is a young, new dentist. The same tooth was worked on every week for over 3 months with her and then I got severe pain in the area.
Then I went to another dentist who misinterpreted all of this as an infection and had three very likely unneeded procedures to try to stop the pain. But in my case, the original trip to the dentist involved no pain and did involve some very unorthodox and likely inexperienced protracted dental work that very likely led to nerve pain. It led to the worst pain I ever felt in my life…I almost fainted in the chair.
I think my nerve pain started with extreme dental trauma caused by an inexperienced dentist…so this is probably ever so slightly different than some other stories. Then to make things worse, I fell victim to other dental “professionals” who took advantage of my pain and performed unneeded surgery with no clear cut reason to do so, worsening my pain/nerve damage…and the tooth was extracted. I think that second part of this mess…is the more common scenario with reference to going to the dentist.
My first MRI did not show compression. I took another today and I’m taking an MRA tomorrow
Mine actually began "out of the blue" as Type 1 - when my MVD was done, my neurosurgeon found a lot of artery & vessel compression once he got in side my head. We have often wondered if he possibly "missed a few more compressions...I think he does too, which is why he wants to see me again the beginning of next month to discuss another MVD...dreading THAT meeting pretty much...:(...But the pain is so much worse now & is CONSTANT which would be considered Type II, that I might just get desparate enough to try it again...we'll see what God has in store! :)
elstep said:
Is the cause of type 2 normally trauma opposed to a compression? How many of us believe it was trauma dental or otherwise that caused type 2 and for how many of us did it come out of the blue?
Lori did he find compressions on ur MRI before he went in? Did u have a fiesta or a 3t MRI? And when did ur type 2 pain start… after ur surgery?
I love to eat and even chow gum, it takes my mind a little bit out of the pain , But the substance of the toothpaste is a trigger it elevate my pain
Ravit I also enjoy eating and it takes away the pain…
@jstagrl - I didn't have an MRI before my MVD because I have a spinal cord stimulator which prevents me from having any MRI's. BUT I did have at CT w/contrast which showed my artery & several vessels in places all over the trigeminal nerve area which made it clear there were compressions. When he went in, that's exactly where they were too! My type II started shortly after my surgery.
@Ravit - sure wish I could eat...that is my worst trigger...and why I've lost so much weight...I LOVE food & chewing gum but can't enjoy either anymore...:/
I have Type1 on my right, and type 2 on my left. However recently I am experiencing classic TN1 zaps on my type 2 side. So weird…
I have well defined triggers on my type 1 side, ( talking, brushing teeth, eating, washing face etc) BUT on my type 2 side not very many triggers that I can define except for cold air, talking and vibration.
I had no dental involvement…
I also experienced an 8 year remission of both TN1 and TN2. It can happen!
My upcoming mvd will be on my type 2 side…as this is the side that is resistant to meds since September.
I am trying to understand Type 2 and what causes it. My understanding is
Nerve Damage through trauma does this mean there is no compression but the nerve is damaged?
Another is it can develop after Type 1 (is this due to nerve damage or a compression?)
The third is it can develop without TN1 or Trauma is this correct? If so, is it a compression that is responsible and if not what is the cause?
Mimi, Good Luck with your upcoming MVD, will be thinking and praying for you, when is it? xx
Elstep, the distinctions you are struggling with are difficult even for professionals. However, here is my basic impression.
There are three general "types" of trigeminal pain.
Type 1 is classic trigeminal neuralgia with its volleys of electric shock pain. This type may or may not be associated with some discrete physical trauma. But fairly often it is found to be associated with vascular compressions in the region close to the emergence of the fifth cranial nerve from the brain stem. MVD is often effective against Type 1 or mixtures of Type 1 and 2 pain.
Type 2 is also believed to be a form of trigeminal neuralgia, but with constant 24-7 burning, boring, throbbing pain rather than volleys, and generally at a somewhat marginally lower intensity. The origins of Type 2 are very often uncertain or unknown. Some of its character suggests that a process other than vascular compression is a cause. In many cases, the cause is assigned as "idiopathic" -- essentially emerging of itself, and not attributable to other causes. MVD is less often effective against Type 2. RF Rhizotomy can be tried with either type, and does help some Type 2 patients. Both procedures are generally less effective, and many neurosurgeons won't do either unless vascular compressions are confirmed in high resolution MRI. Some neurosurgeons propose Gamma Knife as a less invasive solution for Type 2, but the published data are not very promising for GK. About half of all GK patients have recurrent pain within three years, and more patients after that.
Trigeminal Neuropathic Pain is even less precise than Type 2 TN, but is generally associated with some discrete event or trauma. The most frequent candidates I've seen are whiplash injury, dental surgery, over-filling of root canals, maxillo-facial or sinus surgery. The term Neuropathy basically means some form of chemical or mechanical damage to the nerve. But specifics of that damage can be very difficult or impossible to establish. There is overlap in symptoms between neuropathy and Type 2 neuralgia, and the two both tend to be treated with TCA medications, sometimes combined with other booster meds or with the anti-seizure meds.
You are correct that Type 2 may follow Type 1; The opposite is also true. Type 2 has been called "pre" Trigeminal Neuralgia in some published papers, because it can precede some cases of classic or typical Type 1 TN pain. But the mechanism(s) of progression in these conditions are not well understood. It is plausibly speculated that pain may worsen over time due to the accumulation of toxic chemical byproducts of lasting pain in the nerve fibers. But this is a speculation not supported in detail.
There's a lot we don't know, Elstep. But this is my best shot at sorting out what we do know or plausibly speculate.
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Regards, Red
Red thank you