Learn about getting a comprehensive orofacial pain evaluation and become an educated patient.
MS is a chronic disease of the central nervous system. MS can include a wide variety of symptoms and signs, including numbness, paresthesias, pain, weakness, spasticity, fatigue, vertigo, visual difficulties, gait dysfunction, bladder disturbances, and cognitive changes. There appears to be a genetic component to this disease, but the cause of MS is still unknown. Scientists believe that a combination of environmental and genetic factors contribute to the risk of developing MS. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted. Most people with MS are diagnosed between the ages of 20 and 50, with at least two to three times more women than men being diagnosed with the disease.
In MS, damage to the myelin coating around the nerve fibers in the central nervous system (CNS) and to the nerve fibers themselves interferes with the transmission of nerve signals between the brain, spinal cord and the rest of the body. Disrupted nerve signals cause the symptoms of MS, which vary from one person to another and over time for any given individual, depending on where and when the damage occurs.
Facial pain occurs in 1.9-6% of patients diagnosed with multiple sclerosis. In a small percentage of patients, it may be the only presenting symptom. For patients with an established diagnosis of MS, trigeminal neuralgia is the most common associated symptom. When trigeminal neuralgia (TN) is caused by MS, it is referred to as secondary trigeminal neuralgia- there is an underlying disease causing your facial pain. Trigeminal neuralgia almost always occurs on one side of the face, although in MS patients, it occurs more frequently on both sides, in about 18 percent of cases.
Facial Pain in MS is typically:
Surgical therapy is controversial. The early reports found radiofrequency rhizotomy to be useful for the initial treatment of pain; however, the recurrence rate of pain is higher and the duration of pain relief may be shorter. Radiofrequency treatment for TN-MS is still the procedure of choice for most patients. Glycerol treatment may also be an option. Some numbness needs to be produced for the best and longest-lasting results. Studies of MVD surgery for patients with MS have shown a pattern: good initial pain relief with less sustained results. The majority of the FPA Medical Advisory board do not favor MVD for these patients. At the current time, radiofrequency and glycerol procedures have the clearest indications, with more information needed over time for the remaining choices.
People with MS can experience a wide variety of symptoms and signs, including numbness, parenthesis, pain, weakness, spasticity, fatigue, vertigo, visual difficulties, gait dysfunction, bladder disturbances and cognitive changes. As pain can be present in other sites in the course of MS, there are several reports of gabapentin, and lamotrigine being useful for pain in MS. In general, patients with MS are less likely to tolerate the medications used for TN.
For more information on MS, visit the National MS Society.
Dr. Derek Steinbacher, Director of Craniofacial Surgery, Yale Medicine, Chief of Oral Maxillofacial Surgery and Dentistry, FPA Medical Advisory Board member, reviews migraines, TMJ disorders, and dental pain.
Dr. Wolfgang Liedtke will discuss medical treatment of trigeminal neuropathic pain with Dr. Jeffrey Brown.
Wolfgang Liedtke, M.D. Ph.D. is Chair of Neurology, Global Development Scientific Council at Regeneron Pharmaceuticals. Prior to that, he was Professor in the Departments of Neurology, Anesthesiology and Neurobiology; Attending Physician, Duke Neurology Clinics and Clinics for Innovative Pain Therapy, serving patients there for over 17 years.
Dr. Mark Linskey, Dr. Richard Zimmerman, and Megan Hamilton discuss what to look for in the decision making process when you are trying to find a doctor and treatment for facial pain.
Hossein Ansari, MD Director of Headache and Facial Pain Clinic at Kaizen Brain Center Facial pain can be due to a variety of medical conditions. The structure of the face […]
Jennifer M. Wagner, Executive Director of the Western Pain Society, explains the brain-body connection with an emphasis on pain response and provides a list of strategies for those affected by chronic pain.
Dr. Larry Arbeitman will answer: What is Upper Cervical Chiropractic? How does is differ from traditional Chiropractic methods? Learn about the connection between the Upper Cervical Spine and Facial Pain, research and case studies, what you can expect from UCC and how you can integrate it into your healthcare plan. You will also be able to ask Dr. Arbeitman your questions during this live presentation.
Complementary health approaches, also referred to as complementary and alternative medicine (CAM), integrative health therapies, and other terms, refers to a group of diverse medical and health care systems, practices, […]
Dr. Leesa Scott-Morrow will discuss anxiety in people with facial pain.This webinar will introduce the brain mechanisms that are involved in the experience of fear and anxiety, including discussion of […]
In this webinar, Dr. Jeffrey Brown, Chairman of the FPA Medical Advisory Board, talks about the top questions patients and their loved ones have regarding trigeminal neuralgia.
Can Hormones Affect Facial Pain? Some women experience a change in their facial pain at various points in their menstrual cycles, when taking or stopping hormonal methods of birth control, […]
Dr. Raymond Sekula, Professor of Neurosurgery at the University of Pittsburgh School of Medicine and Director of the Cranial Nerve Disorders Program at UPMC, and FPA Medical Advisory Board member reviews the challenges that can complicate the care of people with neuropathic facial pain.
Dr. Jeffrey Brown, Chairman of the Facial Pain Association’s Medical Advisory Board, interviews Dr. Hossein Ansari on medical causes of neuropathic facial pain.
Neuropathic facial pain is diagnosed almost exclusively by the individual’s description of the symptoms. Dr. Kim Burchiel developed a list of questions to help doctors determine exactly which classification may describe a […]
Dr. Deborah Barrett offers a framework and tools to help people improve their quality of life, just as they are, while also reducing pain and suffering. Her work draws from empirically based cognitive and behavioral interventions, and she practices what she preaches every day.
Facial pain can be described in many words…but if you had to choose just one, what would it be? The YPC recently shared how we would describe TN in one word and how we plan to overcome TN.
Dr. Julie Pilitsis, Chair of the Department of Neuroscience & Experimental Therapeutics Professor of Neurosurgery Neuroscience and Experimental Therapeutics, Albany Medical Center and FPA Medical Advisory Board member presents an overview of trigeminal neuralgia and other neuropathic facial pains.
Jeffrey A. Brown, MD, FACS, FAANS First, some basic requirements: there are a lot, but that is the point, too. Doctors educated in the United States are granted their MD […]
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