Monthly Archives: June 2014

What You Need To Know About Trigeminal Neuralgia

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A patient who presents with facial pain when the face is touched, putting makeup on, or even brushing teeth, could have trigeminal neuralgia (TN). The condition is affects the trigeminal nerve that carries nerve impulses from the facial area to the brain. If there is something aggravating this nerve, it will cause abnormal pain sensations to the person affected.

The attacks may be short and mild initially, but the longer it progresses, it could become very painful and frequent. Patients describe it as a searing pain. Trigeminal neuralgia affect women more than men, and people who are older than 50 years of age.


A person may experience one or more of these symptoms:

•    Bouts of pain lasting a few seconds or several seconds.

•    Pain in cheek, lips, gums, teeth, jaw, or possibly the eye or forehead.

•    Attacks become more frequent and worse as time passes on.

•    Frequent attacks lasting days or longer; some people may have periods without pain

•    Attacks triggered by touching the face, chewing, talking, or brushing teeth.

•    Severe pain characterized as shooting or jabbing.

Trigeminal Neuralgia Treatment•    Twinges of mild pain at times.

•    Pain on one side of the face at a time.

•    Pain focused in one area.

If the pain is unrelieved by analgesics like acetaminophen or other over-the-counter pain relievers, make an appointment with the doctor.


Causes of TN may be from the nerve’s function being disrupted. This can be from a normal blood vessel putting pressure on the nerve and causing a problem with its communication with the brain. Another cause of trigeminal neuralgia is aging, or it could be related to multiple sclerosis or other type of disorder that damages the myelin sheath that protects certain nerves. Other issues that are less common are tumors or brain lesions. Sometimes, the cause is unknown.


A trigeminal neuralgia diagnosis is derived from the patient’s medical history. Identifying what symptoms the patient is experiencing as well as physical and neurological tests will help determine whether it is TN. Other disorders of the face will need to be ruled out first, however. There could be an overlapping of symptoms with other facial disorders, such as temporomandibular joint disorder (TMJ) where the pain is in the jaw joint. Because of this overlapping and the large number of facial pain problems that exist, getting the correct diagnosis may prove difficult. It is essential to find the correct diagnosis, however, to provide the proper treatment.

Patients with trigeminal neuralgia will have a magnetic resonance imaging (MRI) scan to check for tumor or multiple sclerosis so that these can be ruled out as causing the facial pain. The scan may show if a blood vessel is pressing into the nerve but not always.

It has been found that if a patient responds favorably to taking a short course of an antiseizure medication for treatment of TN, this confirms the diagnosis. A diagnosis of classic trigeminal neuralgia may be supported by an individual’s positive response to a short course of an antiseizure medication.

pain doctors las vegasTreatment

If it has been confirmed that the patient has TN, there are some treatment options. One is a nerve block or trigeminal block. There are many regions that the nerve block may be done. This treatment will reduce or eliminate the pain from TN.

What Is Diabetic Neuropathy?

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Diabetic neuropathy is essentially the nerve damage that occurs because of problems associated with diabetes mellitus. About 60% to 70% of diabetic patients have some degree of neuropathy. The complications occur in both diabetic populations: type 1 and type 2 patients. The most common type of neuropathy is sensory neuropathy where sensations to the lower extremities decrease. This can lead to loss of protective sensation and results in the worse-case scenarios, lower leg amputation. Sensory neuropathy is sometimes referred to as “stocking-glove neuropathy.” Characteristics include:

•    Loss of sensation

•    Abnormal sensations (paresthesias)

•    Pain

The pain, which is described as burning or cramping can be worse at night. The Diabetic Neuropathyparesthesias may be tingling, burning and itching sensations. The diabetic with sensory neuropathy may feel the sensation of walking on pillows. At times the skin becomes extremely sensitive where even the touch of the bed sheet cannot be tolerated. Complete or partial loss of sensitivity to temperature and touch is common. Foot care is very important because of the possibility of foot injury without the diabetic’s knowledge that the foot had been injured.

The following are recommendations when doing proper diabetic foot care:

– Wash feet daily with mild soap; do not use hot water. Test the water with hands.

– Pat feet dry; ensure the toes are dried in between thoroughly.

– Examine the feet every day for cuts, blisters, sores or other types of problems. Do not depend on “feeling” for them. Use a mirror if needed to see bottoms of feet.

– Use lotion on feet to keep them from drying out, however, do not get lotion in between the toes. Moisture caught between the toes will cause the skin to break down.

– Do not sure over-the-counter remedies for corns or calluses.

– Never use iodine, rubbing alcohol, or strong adhesive tape or bandages.

– Cut toenails straight across even with the rounded contour of the toes. Do not cut down corners. Best time to trim is after a bath or shower.

– Any toes that are overlapping can be separated with cotton.

– Do not use hot water bottles or heating pads. Wear socks to keep feet warm.

– Wear appropriate shoes; no open-toe, open-heel, or high-heel shoes.

– Do not go barefooted.

– Do not wear clothing that cuts off the circulation to the extremities.

– Exercise feet daily by walking or if unable to walk, move feet by flexing and extending feet. This will facilitate blood flow to your lower extremities.

– Do not cross legs; Do no stand or sit for prolonged amounts of time.

It is best to avoid neuropathic problems by addressing the issues as early as possible. Control of blood glucose is the number one way of helping diabetic neuropathy.

Treatments that may be initiated to help diabetic neuropathy are:

– Pain medications

– Neurologic modulating medications

– Laser Treatments

– Regional Nerve Blocks

– Tricyclic Therapy

– Nutritional Supplements

Pain center Las Vegas– Spinal Cord Stimulation