Pain can be remitted, but rarely cured. Acupuncture helps greatly to relieve pain.
Most patients come with essential trigeminal neuralgia, the cause of which is unknown.
The most affected population is between 45-55 years old. Predominant in women. A dental extraction or maxillofacial operation can be a trigger.
Pain is centered on the face; in general there are no other symptoms. Pain crises occur with a certain periodicity, which can last a week or months.
The trigeminal nerve has three branches: the most affected is the middle one, the mandibular, and the first branch less so.
Causes
The cause of trigeminal neuralgia according to traditional Chinese medicine can be internal or external.
- External cause: attack of Wind-Cold or Heat. Obstructs Jing Luo; the obstruction produces pain. See Bi Syndrome
- Internal cause: Fire — fullness or emptiness — obstructs Jin Luo and also produces a Bi syndrome.
- Injury from the seven emotions produces Liver-Qi stagnation which transforms into Fire.
- Improper diet: excessive consumption of pungent foods and condiments that produce Stomach-Heat.
- Constitution of Yin deficiency that transforms into Empty-Heat.
Patterns
- Wind-Cold.
- Wind-Heat.
- LR/ST Fire.
- Yin deficiency with Empty-Heat.
- Qi deficiency with Blood stasis.
Common symptoms
- Pain that appears like lightning, stabbing, burning, cutting, tremendous in intensity.
- Variable duration and frequency of pain episodes.
- Occurs in crises, then disappears.
- Red face, runny nose, facial swelling.
Branches to treat
- Middle branch, most frequent: SI-18, ST-3, LI-20, GB-3. It is mainly Yang Ming; as distal points: LI-4 already included, also ST-41, ST-44. LI-2, LI-5.
Auriculotherapy
Can help control pain: Shen Men, subcortex. Forehead, cheek, upper and lower jaw. On the side where the pain is located. See Auriculotherapy Treatments
Wind-Cold attack
People associate their pain with exposure to Wind-Cold. Watery eyes, clear runny nose, heat in the palm of the hand, cold provokes spasms.
Treatment:
- Common points: Yu Yao, extra point in the middle of the eyebrow. ST-2, Jia Cheng Jiang, ST-7, LI-4 + LR-3.
- Points for the cause: GB-20, LU-7
Wind-Heat
Local burning sensation. Congested and watery eyes. Drooling: Heat relaxes and control of fluids is lost. Red tongue, yellow coating, more rapid pulse.
Treatment:
- Common points: Yu Yao, extra point in the middle of the eyebrow. ST-2, Jia Cheng Jiang, ST-7, LI-4 + LR-3.
- Points for the cause: LI-11, LU-5
LR/ST Fire
Pain with burning sensation; the trigger may be something eaten (stomach) or a context of anger or worry (liver). The Liver divergent channel branches through the cheek, as does the Stomach channel. Liver-Fire and Stomach-Fire differ in the triggering factor of the pain but share the same manifestation. Constipation, nervousness, irritability.
Treatment:
- Common points: Yu Yao, extra point in the middle of the eyebrow. ST-2, Jia Cheng Jiang, ST-7, LI-4 + LR-3.
- Points for the cause: ST-44, LR-2.
Yin deficiency with Empty-Heat
Pain is not as intense. Chronic pattern. Overall depletion of the organism, thinness, very evident loss of vitality. Depressed Shen. Stress and exhaustion trigger it.
Treatment:
- Common points: Yu Yao, extra point in the middle of the eyebrow. ST-2, Jia Cheng Jiang, ST-7, LI-4 + LR-3.
- Points for the cause: KI-6, SP-6
Blood Stasis
Significant chronicity. History of trauma or surgical intervention. Pain can also be triggered by emotions.
Treatment: