Diagnosed With Trigeminal Neuralgia, High Bp. Having Pain On Chest And Face. Are These Related?

Posted on Sat, 30 Mar 2013

Question: I am 34 years old and have recently been diagnosed with TN. I am fit and eat very healthy and they are not sure of the cause. I have shooting pains (periodically just started 2 months ago) on right side of my face, around the jaw. I had a CT and an MRI, waiting on results to rule out tumour, MS. My intuition is kicking in as I have noticed that for years, the vein in my left temple (same side as the TN pain) has been much more pronounced that the left side and it throbbs periodically (with or without a headache on that same side). In addition, I couple yrs ago I was diagnosed with high BP and have experienced periodic chest pains (stress test, ECG all normal but have not had an angiogram). I cant help but feel this is all related. Grandparents on both sides have had HA and stroke. My Dad had a mini-stroke while under going an angiogram. Could the vein that goes to my temple be the vessel that is blocking or hitting the Trigeminal Nerve? Perhaps it has a blockage?? What questions should I pose to my neurologist and GP?

Answered by Dr. Sudhir Kumar (46 minutes later)

Hi,

Thank you for posting your query.

Trigeminal neuralgia (TN) is a common problem, and it has varied causes.

The commonest cause is a blood vessel impingement of the Trigeminal nerve. This can be diagnosed on a good MRI along with MR angiogram, and taking thinner sections through the Trigeminal nerve. Tumor and MS as causes of TN is very uncommon.

Regarding your suspicion about the vein in the temple region blocking or hitting the Trigeminal nerve seems unlikely. In fact, we have two different branches of blood vessel, one that goes inside the brain- XXXXXXX carotid artery & its branches, and the other that comes on temple and face (external)- external carotid artery. So, any problem in the external carotid artery or its branches (that is what we see on the temple) can neither cause TN nor a brain stroke.

I hope it helps. Please get back if you have any more queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX consultant Neurologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (5 hours later)

Great, that was very useful. Sounds like they are likely unrelated. My pains have gone from an electric shock like pain on the left side to a general numbness/dull ache across the jaw line (upper) on both sides. Does this mean it is progressing or does that shed any more light on a possible cause?

Also, have you ever heard of laser therapy to cure TN? There is a laser med center clinic in the U.S. that claims to have a very high success rate. Before I spend any money on something like this, I wanted to get the views of a neurologist to see if this has any merit to it.

Answered by Dr. Sudhir Kumar (2 hours later)

Hi,

Thank you for getting back with mor details.

Numbness is a part of Trigeminal neuralgia in many cases, and this is often the only abnormal finding on clinical examination.

Laser therapy is one of the standard treatments for TN. It is non invasive, as compared to the other treatment- micro vascular decompression (MVD), a surgery. However, the success rate is about 80% with the laser treatment as compared to the surgery. I advise laser treatments in patients who are unfit to undergo surgery due to certain reasons. MRI findings would help us to choose the best treatment modality.

In many cases, medical treatment suffices, with medications such as tegretol. Since your symptoms are of short duration, this may be the best option, if MRI comes as normal.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar