Coping For Those With Cranial Lightening Bolts

Dear Pharmacist . . .

I get weird head pain called trigeminal neuralgia, which is related to mild multiple sclerosis. What are the available treatments? Please answer me. I am in a lot of pain.

     --JS Portland, Oregon--

Trigeminal neuralgia, or TN, causes lightning-bolt shots of pain in the head that just come out of nowhere, starting near the ear and moving around your head, teeth, jaw and eyes. The pain is usually one-sided but it can be bilateral, especially if you have multiple sclerosis. People with MS are much more likely to develop TN.

For some people, the shocks last a few seconds or a minute, then retreat until the next attack. For those who have atypical facial pain or atypical TN, the pain varies but remains constant. It feels like someone plugged your nerves into an electrical socket and then stuck an ice pick in your eye.

You must not give up. There are ways to gain control over your pain. Make sure your doctor has thoroughly tested you. There are many treatments and procedures available that can take the pressure off the trigeminal nerve.

Here is some information, and if any readers have more ideas, feel free to e-mail me so I can pass them along. Remember, these are just suggestions and not intended to replace the advice of your doctor.

1. Medications slow down the electrical firing in your brain and therefore reduce or eliminate TN pain for some people. Neurologists often use anti-epileptic drugs such as Tegretol (carbamazepine), Neurontin (gabapentin) and Dilantin (phenytoin), among others. Baclofen and Zanaflex are other considerations.

2. If you have multiple sclerosis, your facial neuralgias could be related to a process called demyelination, a big word for what happens when nerve cells (neurons) lose their outer coating, or insulation. When neurons demyelinate, a lot of weird nervous-system problems results, such as sensations of hot water pouring down your leg or someone pulling one of your toes.

3. Certain OTC supplements may nourish neurons and help reinsulate you. Ask your neurologist about methylcobalamin, DHA (docosahexanoic acid, a fish oil extract), vitamin D, SAMe, NAC, progesterone, coenzyme Q10, GABA, magnesium, Methyl Guard and Brain Sustain (www.brainsustain.com).

4. Run a hand towel under hot water, then lay it over your face (but leave your nose free to breathe!) — then apply pressure to each side of your face.

5. Apply capsaicin cream to your face and/or head where it hurts. When the hot sensation is gone, reapply it, usually every three to six hours. This should numb nerve endings within a week or two. Avoid eye area and wash hands well.

6. Use ice packs or hot packs, whichever feels better.

7. In the 11 states where it is decriminalized, cannabis (yes, marijuana) is used medicinally and prescribed by doctors to control intractable pain. In other states, doctors prescribe the drug version, Marinol, which is sold at some pharmacies. The herb stimulates receptors in the brain and may abort a TN attack within minutes.

8. Acupuncture helps some people.

9. Get a gluten and casein antibody blood test. Removing offending allergenic foods will allow your nerves to remyelinate.

10. See your physician routinely for lab work, especially if you take medications.

     --Suzy--