Computer program lets people with Trigeminal neuralgia diagnose themselves

trigeminal-neuralgia2Trigeminal neuralgia, or TN, is a medical condition that affects areas of the face where the trigeminal nerve’s branches are distributed. These areas would include the eyes, lips, scalp, nose, forehead, upper and lower jaws. The condition is often caused by an artery that causes compression to the nerve. This will result in the person feeling mind-numbing, stabbing electric shock-like pain.

This condition said to book the most severe types of pain known to humanity. The most common forms of trigeminal neuralgia affects 1 in 15,000 to 20,000, but 1 in 5,000 are thought to suffer from some type of facial pain.

This condition is often known as the suicide disease as the people are often in total agony. For some people if they touch their eyebrow it feels as if they stuck their finger in an electrical outlet. If they go outside and the wind touches their face, it will feel like the most intense toothache ever.

Despite the pain, new research has developed a new method for classifying and diagnosing TN. This method will allow the patient to do much of the diagnosis themselves. A research team has developed the world’s first online, artificial neural network to be used as a diagnostic tool for facial pain syndromes. It is an artificial intelligence-based computer program built around a classification scheme that categorizes forms of the disorder, and it can be trained to recognize patterns in facial pain data and continually improve its accuracy in predicting the correct diagnosis.

If a patient is able to have an accurate diagnosis, that means they will be able to quickly seek appropriate treatment. Sometimes a patient may state that there have been a pain and go to the dentist, from there the dentist might give them a root canal. This could continue until it is decided that the source of the pain might be something else.

The main researcher has used an 18-point questionnaire he developed that will allow him to clinically diagnose facial pain. Since facial pain types are based almost solely on a patient’s medical history, the questionnaire is comprised of yes-or-no questions that tend to make a difference in establishing the target diagnosis, such as whether the patient has multiple sclerosis, has suffered a facial injury or has had surgery for facial pain, and whether the pain is on just one side of the face or manifests during certain daily activities, like shaving or eating.

The responses they get from the questionnaire is then used to place the patient into one of seven trigeminal neuralgia categories. Type 1: or spontaneous, but severe and brief pain. Type 2: or spontaneous, more constant pain; trigeminal neuropathic pain from facial trauma, oral surgery, stroke or other causes; trigeminal deafferentation pain from procedures that intentionally injure the trigeminal nerve system to relieve other pain; symptomatic trigeminal neuralgia from multiple sclerosis; postherpetic neuralgia from trigeminal shingles; and atypical facial pain, which is more psychological rather than physiological in origin.

Burchiel doesn’t think patients should have to wait until a clinic visit to get a diagnosis, so he developed the artificial neural network, which patients can easily, and confidentially, access on the OHSU Department of Neurological Surgery’s Web site.

The computer system when used was able to accurately diagnose most of the patients who suffered from the condition. It also correctly diagnosed trigeminal neuralgia Type 1 with 84 percent sensitivity and 83 percent specificity among another 43 new patients who used the network before their clinic diagnosis. Sensitivity is a measure of a diagnostic tool’s ability to make a correct diagnosis, and specificity describes its ability to avoid a misdiagnosis.

One treatment for trigeminal neuralgia is surgery that is calledmicrovascular decompression. The procedure involves entering the brain through a small incision behind the ear. Once in there, the doctor will try to find and expose the trigeminal nerve with a powerful surgical microscope. The doctor will then position a piece of Teflon between the nerve and the artery that’s touching it and causing the pain.

Generally the procedure will offer longer-term relief from facial pain.

Oxycarbazepine As Effective As Carbamazepine in Treating Trigeminal Neuralgia

oxycarbazepineOxycarbazepine  (OXYCARBAZEPINE  ), a keto-analog of carbamazepine (CARBAMAZEPINE), is as almost as effective as carbamazepine for the treatment of the condition trigeminal neuralgia. A double study conducted the shoulder it is better tolerated.

A study was conducted at the University of Michigan the in Ann Arbor, Michigan to look at the findings of Oxycarbazepine  arbazine on a study group. The researchers had 46 patients were over the age of 40 years old in the clinical trial. These people had new onset, previously untreated idiopathic trigeminal neuralgia. 24 patients were randomized to receive Oxycarbazepine  and 22 to receive Carbamazepine.

All patients over a two- to four-week period were given an initial dose 300 mg Oxycarbazepine  twice daily or 200 mg carbamazepine twice daily. This was then followed by a four-week maintenance period.

The most frequently doses used were Oxycarbazepine 750 mg per day and Carbamazepine 500 mg per day. Researchers noted that there were no significant differences between the groups for any efficacy variable.

In the two groups, 100% of patients responded to treatment and 50% became pain-free. 70% of those who were taking Oxycarbazepine had a significant reduction in pain compared to 59% of those who took Carbamazepine.

One patient in the Oxycarbazepine group discontinued treatment due to a rash.

The results that researchers gained from this study suggested that Oxycarbazepine is an effective treatment alternative to Carbamazepine for patients who suffer from new onset trigeminal neuralgia.

Trigeminal Neuralgia Is One Of The Worst Pains

trigeminal-neuralgia1For people who have this antagonizing pain that affect side of the face and can’t explain where it comes from, might be suffering from a medical condition called could mean longer routes. This pain might come about from shaving, chewing, washing the face, brushing the teeth and it might be excruciating or feel like an electric shock.

This pain is considered to be one of the worst pains a person can have. Some think it’s a dental problem it can be triggered by anything.

Trigeminal neuralgia is a disorder of the trigeminal nerve. The trigeminal nerve is divided into three branches: the mandibular nerve which controls sensation in the lower jaw bones which assist in chewing; the maxillary nerve which controls sensation in the upper jaws, where most of the teeth are in higher vertebrates; and the ophthalmic nerve which provides sensation to the eyes, particularly the cornea.

Trigeminal neuralgia, however, is a disorder marked by a “wearing out” of the nerves and usually occurring in the lower maxillary and mandibular branches.

 The pain associated with condition can vary in severity. Some patients will have mild pain, while some people may have it for a month.

People often complain that the pain they feel is associated with a dental problem. Dentists should be able to recognize that this pain is associated with trigeminal neuralgia if their patients complain that every time they brush their teeth or wash their face they have an electric shock pain.

The trigeminal nerve is responsible for chewing, producing saliva and tears, and for sending facial sensations to the brain. In trigeminal neuralgia, when the nerves “short circuit” usually on one side of the face, the pain is often unbearable.

 The condition however is not life-threatening. If untreated however, it can get a lot worse. The nerve can be damaged over time and the person will have a constant dull ache.

There are various treatments that are available to help treat the condition. There are drug treatments that can help to reduce the sensitivity of the nerve. The anti-epilepsy medicine Tegretol is also used.  There is the possibility of having surgery done on the nerve to remove whatever is compressing it.

Another treatment used is radial frequency ablation, a procedure through which doctors induce radio-frequency waves, gamma rays, or glycerol injections to deaden the nerve — and the pain.

Acupuncture is another treatment that can be considered and some people have stated success with what they have done.

Radiosurgery Helps With Trigeminal Neuralgia

radiosurgeryFor people who suffer from trigeminal neuralgia, radiosurgery is a non-invasive radiation technique that is a safe and effective treatment. Trigeminal neuralgia is a condition that consists of episodes of intense stabbing pain in the face and neck.

X-rays are taken and they locate the place where highly focused beams of radiation should be placed. Radiosurgery seems to improve trigeminal neuralgia by selectively destroying nerves that carry pain signals.

Radiosurgery has typically been limited to treat people who have shown no improvement of trigeminal neuralgia after conventional surgery has failed. In recent years however, radiosurgery has started to be offered as the main therapy for the condition.

In the current study, radiosurgery was performed on 22 patients with trigeminal neuralgia. All of the patients in the study had all failed to respond to drug therapy.

After a follow up after 21 months, pain relief was rated as excellent for 15 patients, good for 6, and poor for 1, yielding a total success rate of 95.4 percent. Generally the reduction in pain occurred 3 months after the procedure. Five patients experienced pain recurrence, but in generally in all cases, the pain was less than before.

The results showed that the use of the available radiosurgery technique is a good first option for people who suffer from this condition. It should be noted that radiosurgery is not suitable for patients will suffer from severe acute pain episodes.

Trigeminal Neuralgia in Dentistry

dentistDentists should be aware of patients who complain about a toothache or pain of their sinuses, with no real dental cause, might be suffering from the medical condition called trigeminal neuralgia.

The symptoms associated with this condition is usually a sharp, stabbing pain that can be aggravated by brushing teeth, cold liquids, chewing gum/food or talking.

Misdiagnosis of trigeminal neuralgia can often result in unnecessary dental procedures such as multiple extractions, endodontic procedures, and TMJ surgery. All of these are done and they have no effect of the discomfort that patient feels.

The medical condition trigeminal neuralgia is caused when the blood vessel at the trigemenal nerve root entry-exit zone is compressed. The pain the person who suffers from this condition is one of the most painful. The symptoms associated with the condition are very mild in the early stages, however it will increase in intensity over time. The person will experience electric shock like pain as it progresses.

Trigeminal neuralgia can be triggered by the slightest of stimulations. This can result in a painful attack for the patient. It should be noted that around 25% of people who have the condition will respond to treatments of anticonvulsant drugs. For the others, surgery is required.

Trigeminal Neuralgia has distinct symptoms that separate it from other forms of facial pain.

  •          The pain is acute, short bursts as opposed to a dull, constant ache.
  •          The pain is often described as electric shock-like in nature.
  •          The pain can be triggered by light touch or sensitivity to vibrations such as eating, shaving, brushing teeth or talking
  •          The pain will come and go. Sometimes it will be intense; while other times the person will be pain free.

The medical history of the patient and the description of the some are major ways of identifying trigeminal neuralgia. Many doctors will often recommend that the patient gets a MRI or CAT scan to rule out other possible cause of pain. There is no specific test to diagnose Trigeminal Neuralgia.

OHSU School of Dentistry Resident Uncovers Mechanisms for Dental Pain

Oregon Health & Science University’s School of Dentistry have discovered a novel function of the peptide known as Nerve Growth Factor (NGF) in the development of the trigeminal nerve. The trigeminal nerve provides the signaling pathway for periodontal pain, dental surgical pain, and pain associated with temporomandibular disorder, trigeminal neuralgia, migraine, and other neuropathic and inflammatory conditions. The study is posted online in the journal Neuropeptides and will appear in print issues of that journal in early 2009.

( – Oregon Health & Science University’s School of Dentistry have discovered a novel function of the peptide known as Nerve Growth Factor ( NGF ) in the development of the trigeminal nerve. The trigeminal nerve provides the signaling pathway for periodontal pain, dental surgical pain, and pain associated with temporomandibular disorder, trigeminal neuralgia, migraine, and other neuropathic and inflammatory conditions.
The study is posted online in the journal Neuropeptides and will appear in print issues of that journal in early 2009.

Working with researchers in the dental school departments of Endodontology and Integrative Biosciences, second-year endodontology resident and lead author of the study, Leila Tarsa, D.D.S., M.S., found a new mechanism involved in establishing junctions – known as synapses – between trigeminal nerve cells. Nerve cells communicate with one another through chemicals called transmitters that are released at synapses. The transmitter release from nerve cells endings is possible only if aided by several molecules that are critical for proper function of the synapse. Tarsa’s research shows that NGF promotes transport of one of the molecules ( called synaptophysin ) from the nerve cell body to its ending.

“The data indicate that NGF participates in formation of neuronal connections in the trigeminal system,” said Agnieszka Balkowiec, M.D., Ph.D., OHSU School of Dentistry assistant professor of integrative biosciences and OHSU School of Medicine adjunct assistant professor of physiology and pharmacology, who is the senior author of the study and whose lab hosted the research. “This study has broad implications for trigeminal nerve regeneration.”

The study was supported by grants from the National Institutes of Health and the Medical Research Foundation of Oregon.

About OHSU

Oregon Health & Science University is the state’s only health and research university and Oregon’s only academic health center. ( excluding government ), with 12,700 employees. OHSU’s size contributes to its ability to provide many services and community support activities not found anywhere else in the state.