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Facial Pain: When a Nerve Is a Live Wire
Of all the places in the body that can hurt, the face might seem the strangest. But for some people, that's exactly where the agony occurs, and the cause is a nerve gone haywire.
How peripheral nerves involve themselves in pain is sometimes confusing. Here's a handy way to think of the two basic patterns:
#1: The nerve is the messenger. If you have a dental abscess, a facial sunburn or a sinus infection, you can count on pain being present. Where does it come from? Special nerve endings detect the tissue-injury and generate electrical impulses. The peripheral nerves carry these impulses into the brain. The peripheral nerves didn't CAUSE the pain, they're just carrying the bad news. (Don't shoot the messenger!)
#2: The nerve itself is the mischief-maker. In some cases the nerve generates abnormal impulses on its own. The nerve is still capable of carrying normal impulses, like those informing the brain that the skin of the face is warm or cold-or that you cut yourself shaving-but generates signals of its own as well that the brain can only interpret as painful.
When peripheral nerves generate bolts of pain in the forehead, eye, cheek or jaw, it's called trigeminal neuralgia. This technical term can be broken into its parts, starting at the end and working forward. "Algia" means pain. A "neur-algia" means nerve-pain. Finally, "trigeminal" is the name of the nerve involved. So "trigeminal neuralgia" means pain caused by the trigeminal nerve. We have two trigeminal nerves, one for each side of the face. They are among the largest nerves in our heads.
An older term for trigeminal neuralgia was "tic douloureux." This bears explaining. A "tic" is a sudden, brief movement. "Douloureux" is the French word for "painful." So a "tic douloureux" means that a sudden, brief movement and a pain occur together. However, this terminology was largely abandoned because it implies that movement is an essential feature. It isn't. When movement is present, it's just as a reaction to the pain.
So what are the usual features of trigeminal neuralgia? First of all, it almost always occurs on just one side of the face. If one of our trigeminal nerves gets involved in this unfortunate condition, it's rare indeed that the second trigeminal nerve would be so unlucky to get involved, too. Or another way of looking at it is this: if the pain switches sides or crosses the midline, then it's probably not trigeminal neuralgia.
Trigeminal neuralgia usually involves brief, but intense jabs of pain, though is sometimes more steady and continuous. It can also get revved-up by external stimuli, like washing the face, putting on make-up, brushing teeth, chewing-and sometimes just talking.
The most usual form of trigeminal neuralgia begins after the age of 50. And, once present, it tends to hang around. Its course-like that of the stock market-fluctuates.
Treatment is not usually curative, but help is still available. Most patients obtain relief through one or a combination of medications that either simmer down the extra nerve-impulses or reduce the effects of the barrage of extra signals that arrive in the brain. Some of their generic names are carbamazepine, gabapentin, baclofen, clonazepam and lamotrigine.
A minority of patients with this condition undertake surgery for it. One surgery involves purposely damaging the trigeminal nerve-fibers where they gather together in a structure called a ganglion. This approach is fairly safe, but produces partial numbness on the face.
Another surgery goes straight to where the trigeminal nerve fibers meet the brain. The surgeon gently separates the nerve from its surrounding tissues. The good part of this procedure is that it doesn't seek to damage tissue. The downside is that the location for the surgery is at an important cross-roads for many nerve and brain pathways, so a complication can be devastating. While some people get long-lasting relief from the surgeries, others obtain just temporary respite.
While the foregoing summary of treatments sounds gloomy, it's important to realize that most people who seek medical treatment for their trigeminal neuralgia are able to arrive at a happy point where pain is minimized and quality of life is maximized. The neuralgia no longer rules their lives; instead, they're in control of the neuralgia.
(C) 2005 by Gary Cordingley
Gary Cordingley MD, PhD, is a clinical neurologist, teacher and researcher. For more health-related information, see his website at: http://www.cordingleyneurology.com
Toenail Fungus: Treatment and Prevention
A thick, yellowish nail with splotchy white areas is a classic presentation for a fungal toenail. In the early stages the toenail is only slightly discolored, or slightly thickened. In the late stages the nail can become very thick and has a tendency to "grow up" more than in grows out. The nail will be very discolored, typically dark yellow-brown and will start to change shape and crumble. In some cases the nail becomes very loose and many will lose the nail, only for it to regrow with the fungus.
Thimerosal: Autism and Mercury Poisoning Side Effects?
Thimerosal is a preservative that is added to vaccines (has been since the 1930s) that is almost half (49.6% by weight) mercury. Preservatives are added to vaccines to prevent bacteria and fungi from growing. These vaccines include antivenins, skin test antigens, ophthalmic and nasal products. Thimerosal preserved vaccines have been given to children as well as adults.
The Basic First Aid for Child Care Programs
We cannot help but accept the fact that children do get into trouble and sometimes emergencies when they are left in childcare programs. We just have to pray that most injuries sustained are minor such as cuts, scrapes, bruises, among others.
Onychomycosis - One Of The Many Nail Fungus Out There
Many natural changes in fingers and toenails come with age. Fine ridges, for example, may start developing from the cuticle of the nail tip. This and other similar changes are common, but they are not signs of poor health.
Bextra and Vioxx Withdrawal Spawn Advertising Pause from Bristol Myers
Pharmaceutical giant Bristol Myers Squibb has announced that they will suspend direct-to-consumer advertising for their prescription drug products for a year. This comes in the wake of the well-publicized withdrawals of Merck's Vioxx and Pfizer's Bextra, two non-steroidal anti-inflammatory drugs (NSAIDs) that were voluntarily withdrawn from the market recently. Studies showed that they increase the likelihood of strokes and heart attacks among patients that take them for prolonged periods of time. This represents an unusual move for a pharmaceutical company, as they tend to spend a large portion of their annual advertising budget on direct-to-consumer advertising.
Are You Suffering From Addiction?
Many researchers believe that addiction is a behavior that can be controlled to some extent and also a brain disease. And since some testing with functional magnetic resonance imaging (FMRI) found that all addictions tend to cause nearly the same reactions inside the brain, there could be one type of control model for addiction health-related issues.
ADHD - Are there Treatment Options?
As an ADD coach I am often asked about the treatment options available for Attention Deficit Disorder. Generally when someone says "ADD" the first thing that will come to the layperson's mind is 'Ritalin' or an image of a hyperactive "Dennis-the-Menace" type. Fortunately, there is a lot more to Attention Deficit Disorder than drugs and hyperactivity. Each individual is unique and therefore different people will respond well to different treatment options.
How You Can Erase Low Back Pain Using the Latest Medical Techniques!
"If you're one the nine out of ten adults in the United States who suffers from low back pain, I have good news for you!" states Dr. Nathan Wei, a board-certified rheumatologist and Clinical Director of the Arthritis and Osteoporosis Center of Maryland.
Why Drug Companies are Naughty and 5 Remedies to Cure the Symptoms
With the hum of the election campaign and the debate of "big business," versus human interest, I decided to do a bit of muckraking into the art and science of the recent removal of Merck's Vioxx. My motivation of course; to look for clues as to the role drug companies play in our health and wellness (or lack thereof).
What is R.I.C.E. and why do you need it? One of the most recommended icing techniques for reducing inflammation and treating minor injuries is R.I.C.E., an acronym for rest, ice, compression and elevation. It is best used for pulled muscles, sprained ligaments, soft tissue injury, and joint aches. Applying R.I.C.E. treatments will decrease pain, inflammation, muscle spasms, swelling and tissue damage. It achieves this by reducing blood flow from local vessels near the injury and decreasing fluid hemorrhaging as a result of cell damage.
Top Ten Things You Should Know About Contact Lenses
1. Soft lenses are perceived by most patients and practitioners alike to be more immediately comfortable while adequately correcting vision. They come in all formats - even toric and bifocal. Disposable soft lenses take minimal but important care to maintain their safety and usefulness.
Substance Abuse Attitude Testing by a Standardized Survey
This is a short overview of a questionnaire used for substance abuse attitude testing in testing a CREATE (Curriculum Renewal and Evaluation of Addiction Training and Education) effects on Medical Students. My afterthoughts on substance abuse attitude testing are in the end of the article.
Bextra and Vioxx -- Alternative Medications Have Warnings, Too
At the urging of the Food and Drug Administration, the drugs Vioxx and Bextra have both been voluntarily withdrawn from the market by their manufacturers. Studies show that these drugs, part of a family of non-steroidal anti-inflammatory drugs (NSAID) known as COX-2 inhibitors, may be linked to increased chances of heart attack or stroke.
Rezulin Liver Failure Causes FDA to Recall Drug
Rezulin, a prescription type 2 diabetes drug has been withdrawn from the market by the FDA. New drugs have come out which offer the benefits that Rezulin provides but without such damaging side effects. Rezulin caused extreme damage to the liver that often resulted in liver failure. Liver failure was so widespread amongst Rezulin users that there has been progressively increasing encouragement for these people to have frequent liver function tests to monitor liver damage. In fact, Rezulin users are 1200 times more likely to have liver failure than non-users of the drug.
Lunesta is a newly released sleeping pill. Marketed as a revolutionary sleep aid, Lunesta is the only medication approved by the FDA for long term treatment of insomnia symptoms. Although Lunesta is a quality medicine that has already helped many people cure their insomnia symptoms and get a better night's sleep, there is something you should know before your buy Lunesta.
A Compelling Look at Pain Relief
If your back aches when you're loading groceries in the car or your hands cramp up with arthritis when you sit down at the computer, you're not alone. Although the nature, cause, and complaints vary, over one-half of Americans experience chronic or recurrent pain, a recent survey conducted by the Stanford University Medical Center found.
The Right Medical Equipment For You Home Or Practice!
Quality, dependable Medical Equipment is an important component of every medical practice. It can't be overstated that while the practice of medicine is an art, Medical Equipment is the science behind the implementation of that art.
Orthotics: Prefab or Custom-Made?
If you take a simple stroll down the foot product isle at your local drug store you will find an array of foot products and inserts. You will find inserts for cushion, for comfort, for support and for control. Many questions may cross your mind. What are the differences? Is the $15 insert better than the $7 insert? Are these orthotics? Will they help my foot pain? You may take the time to study the package details closely, but in most instances it doesn't really matter which pair you grab. Most of the inserts at the local drug store are essentially the same.
Exposing the Miracle Cure
It was Saturday morning and while I was making breakfast, letting the cats outside, and watering my half-dead plants, I had the TV on. Saturday morning TV is usually composed of nothing but infomercials and today was no different.
Overview of FDA Recalled Drug - BEXTRA
Bextra, also known as valdecoxib, is a prescription medicine known as a COX-2 Inhibitor. Like Vioxx and Celebrex, it supposedly lessen the pain of inflammation and fever without causing stomach irritation common to aspirin and other NSAIDs (Non-Steroidal Anti-Inflammatory Drugs). Pharmaceutical corporation Pfizer released Bextra in 2001, and prescription sales soon rose to 3.2 billion dollars.
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