trigeminal

Trigeminal neuralgia (TN) is a type of chronic pain that affects your face. It causes extreme, sudden burning or shock-like pain. It usually affects one side of the face. Any vibration on your face, even from talking, can set it off. The condition may come and go, disappearing for days or even months. But the longer you have it, the less often it goes away.

TN usually affects people over 50, especially women. The cause is probably a blood vessel pressing on the trigeminal nerve, one of the largest nerves in the head. Tumors and multiple sclerosis can also cause TN, but in some cases the cause is unknown.

There is no specific test for TN. It can be hard to diagnose, since many other conditions can cause facial pain. Treatment options include medicines, surgery, and complementary techniques.

NIH: National Institute of Neurological Disorders and Stroke

Face injuries and disorders can cause pain and affect how you look. In severe cases, they can affect sight, speech, breathing and your ability to swallow. Fractures (broken bones), especially in the bones of your nose, cheekbone and jaw, are common facial injuries.

Certain diseases also lead to facial disorders. For example, nerve diseases like trigeminal neuralgia or Bell's palsy sometimes cause facial pain, spasms and trouble with eye or facial movement. Birth defects can also affect the face. They can cause underdeveloped or unusually prominent facial features or a lack of facial expression. Cleft lip and palate are a common facial birth defect.

Your jaw is a set of bones that holds your teeth. It includes:

• The maxilla, which is the upper part of your jaw. It holds your top teeth in place and doesn't move. It also supports the muscles involved in chewing and facial expressions.
• The mandible, which is the lower part of your jaw. You move it when you talk or chew. It also holds your lower teeth in place.
• The temporomandibular joints (TMJs), which are two joints (one on each side) that connect your mandible to your skull.

Jaw problems can include:

• Fractures (broken bones).
• Dislocations, which are joint injuries that force the ends of your bones out of position.
• Temporomandibular disorders (TMDs), which are conditions that affect your TMJs.
• Osteonecrosis, which happens when the blood flow to part of your bone is disrupted. It can cause the bone to break down.
• Jaw tumors, which can be benign (not cancer) or cancer.
• Jaw defects, which are birth defects in which your jaw could be missing or deformed.

Diagnostic imaging tests are often used to diagnose jaw injuries and disorders. Your treatment will depend on which jaw problem you have.

The brain, spinal cord, and nerves make up the nervous system. Together they control all the workings of the body. When something goes wrong with a part of your nervous system, you can have trouble moving, speaking, swallowing, breathing, or learning. You can also have problems with your memory, senses, or mood.

There are more than 600 neurologic diseases. Major types include:

• Diseases caused by faulty genes, such as Huntington's disease and muscular dystrophy
• Problems with the way the nervous system develops, such as spina bifida
• Degenerative diseases, where nerve cells are damaged or die, such as Parkinson's disease and Alzheimer's disease
• Diseases of the blood vessels that supply the brain, such as stroke
• Injuries to the spinal cord and brain
• Seizure disorders, such as epilepsy
• Cancer, such as brain tumors
• infections, such as meningitis

Pain is a signal in your nervous system that something may be wrong. It is an unpleasant feeling, such as a prick, tingle, sting, burn, or ache. Pain may be sharp or dull. It may come and go, or it may be constant. You may feel pain in one area of your body, such as your back, abdomen, chest, pelvis, or you may feel pain all over.

Pain can be helpful in diagnosing a problem. If you never felt pain, you might seriously hurt yourself without knowing it, or you might not realize you have a medical problem that needs treatment.

There are two types of pain: acute and chronic. Acute pain usually comes on suddenly, because of a disease, injury, or inflammation. It can often be diagnosed and treated. It usually goes away, though sometimes it can turn into chronic pain. Chronic pain lasts for a long time, and can cause severe problems.

Pain is not always curable, but there are many ways to treat it. Treatment depends on the cause and type of pain. There are drug treatments, including pain relievers. There are also non-drug treatments, such as acupuncture, physical therapy, and sometimes surgery.

NIH: National Institute of Neurological Disorders and Stroke

Nerves are like wires that carry messages back and forth between your brain and your body. Your peripheral nerves branch off from your brain and spinal cord and connect to all parts of your body, including your muscles and organs. Peripheral nerves carry messages from your brain that control your movement, breathing, heartbeat, digestion, and more. They also carry messages from your body to your brain, so you can feel things, such as pain, heat, and cold.

Peripheral nerve disorders happen when one or more peripheral nerves are damaged. Damaged nerves may not carry messages correctly, or they may not work at all. As a result, you may have pain, trouble walking, or a variety of other problems, depending on which nerves are involved.

Peripheral nerve disorders are very common. There are more than 100 different types.

Many things can damage nerves and lead to peripheral nerve disorders:

• Diabetes is the most common cause of peripheral nerve disorders. Most people with diabetes will develop diabetic nerve problems.
• Physical injury (trauma) that stretches, crushes, squeezes, cuts, or puts pressure on one or more nerves. Some examples of peripheral nerve disorders from physical injury include complex regional pain syndrome and brachial plexus injuries.
• Health conditions, including:
  • Certain cancers and their treatment (chemotherapy and radiation therapy).
  • Infections, such as HIV and Lyme disease.
  • Problems with blood or blood vessels.
  • Autoimmune diseases, such as rheumatoid arthritis and lupus.
  • Kidney or liver disease.
• Certain medicines.
• Contact with certain toxic substances, such as lead or mercury.
• Alcohol use disorder (AUD) and smoking.
• Vitamin imbalances, especially a lack of vitamin B12.
• Your genes, including changes in your genes or conditions that you inherit from your parents, such as Charcot-Marie-Tooth disease.

In certain cases, the cause of peripheral nerve disorder is not known.

The symptoms of peripheral nerve disorders depend on which nerves are affected, what is causing the damage, and how serious it is:

• Weak or aching muscles
• Problems with balance, walking, or using your arms and hands
• Cramps or twitching muscles
• Muscle shrinking

• Tingling, numbness, or pain often in the hands and feet
• Not being able to feel heat, cold, or pain, such as a cut on your foot
• Pain from even light touch

• A heartbeat that's too fast or too slow
• Trouble swallowing
• Sweating too much or too little
• Vomiting, diarrhea, or constipation
• Problems with urination or sexual function

Symptoms may range from mild to very strong. They may develop quickly over days or slowly over months and years. But they are rarely life-threatening.

To find out if you have a peripheral nerve disorder, your provider will:

• Ask about your medical history
• Ask about your family health history
• Do a physical exam
• Order tests, which may include:
  • Blood tests
  • Genetic tests
  • Nerve tests that measure:
    • Electrical activity in your nerves and muscles
    • How well your autonomic nerves are working
  • A biopsy of nerve or skin tissue
  • CT or MRI scan to see what may be pressing on your nerves

It's important to treat any conditions that are causing nerve damage. In certain cases, that will allow your nerves to heal over time.

Treatment for symptoms depends on the type of peripheral nerve disorder you have, where it is, and how severe. Treatment options include:

• Braces or splints
• Over-the-counter patches and skin creams
• Prescription medicines
• Non-drug pain management, such as electrical stimulation or relaxation therapy
• Surgery to relieve pressure on a nerve

You can help prevent peripheral nerve disorders by:

• Managing health conditions that may cause nerve damage, especially diabetes
• Preventing falls and accidents
• Avoiding toxic substances
• Being careful to avoid repeated motions and body positions that press on your nerves
• Eating a balanced diet, exercising, limiting alcohol, and not smoking

NIH: National Institute of Neurological Disorders and Stroke