Husband’s facial nerve pain comes in waves, lasts months

Dear Dr. Roach: My husband suffers from trigeminal neuralgia. This is often very painful for months at a time, then will stop for months before it begins again. He does not want antiseizure medication. Are there any natural remedies? — B.K.

Dear B.K.: Trigeminal neuralgia is a pain syndrome involving the trigeminal nerve, which provides the sensation to the face in three bands: the eye and scalp, upper jaw and nose, and lower jaw and ear.

The pain of trigeminal neuralgia tends to be intermittent, coming in spasms. The pain is often described as being like an electric shock or stabbing sensation. However, some people have continuous pain. The diagnosis of trigeminal neuralgia is frequently delayed, as physicians and dentists may not recognize the pain as coming from the nerve.

Your husbands experience — episodes lasting for weeks to months followed by a painfree interval, lasting months to years — is also very common.

First-line treatment are medications that slow down the firing of nerve cells by blocking the sodium channel. Carbamazepine, oxcarbazepine and gabapentin all are medications that have been studied for treatment of trigeminal neuralgia. I am unaware of any herbs or other materials found in nature, with the possible exception of injected purified botulinum toxin (Botox and others), made by bacteria, with some evidence to support its use in people who do not respond to first-line therapies.

I’d recommend some websites that offer further information and support groups: livingwithtn.org, fpa-support.org, and tnnme. com.