Pleading the Fifth and Trigeminal Neuralgia

Trigeminal neuralgia is often described as the most excruciating form of human pain. (Photo by clarita at


“Pleading the fifth” to avoid self-incrimination in a court of law is a common occurrence.  However, in the context of this blog post we are referring to the 5th cranial nerve called the trigeminal nerve, which provides facial sensations of touch and pain.  As we approach International Trigeminal Neuralgia Awareness Day (Oct. 7, 2016) our goal is to raise awareness of this excruciating pain syndrome and to provide a holistic perspective on the disorder.

Neuralgia can affect any nerve in our bodies and many people have felt it at one time or another.  It manifests itself as a burning or stabbing pain that can last from several seconds to weeks, months or years.  If you have felt the pain of neuralgia and would like to share, feel free to use the  comments section below.

On several occasions, I have felt a sudden pulsating stabbing pain on the back of my index finger, or in my eye.  Thank god the pain did not last more than several seconds!  However, there are many people who endure this pain on a continuous basis.  Other times I have felt a pain in my jaw that goes away only if I cover the area with a Faraday type shield.   This makes me wonder if many people experience TN from time to time without the problem ever becoming prolonged enough for them to seek medical attention.

What are the causes of Trigeminal Neuralgia (TN)

In trigeminal neuralgia the pain can affect the face, jaws, teeth or eyes.  The level of pain has been described as the most severe pain known to humankind.  The cause is often unknown, but Katsuhiro Toda, Chief of the Department of Rehabilitation, Hatsukaichi Memorial Hospital in Japan lists the following possibilities:

  •   Neurovascular compression of the nerve:  As we age blood vessels and arteries in the brain continue to elongate.  This can result in pressure being applied to the trigeminal nerve.  It is believed that the constant pressure from these blood vessels can cause the insulating myelin of the nerve to wear out resulting in shorting out of the nerves, or excessive cross-talk.  However, it has been shown that many people with apparent neurovascular compression do not have TN and are non-symptomatic.  This indicates that problem may be one of hypersensitivity of the nerves such that contact or compression feeds into the underlying problem.
  • Multiple Sclerosis (MS):  TN is the first symptom of MS in 9% to 14% of patients.  In MS, the immune system attacks and destroys the myelin insulation around the neurons in the trigeminal nerve resulting in defective transmission of nerve impulses.  Interestingly diets low in saturated fat (meat and dairy) and higher in omega 3 fatty acids (fish, flax seeds) helped limit the progression of MS and may also help with TN.
  • Tumor / Cyst / Aneurism
  • Diabetes Mellitus:  Diabetes appears to increase the risk of TN about fivefold.  TN may be resolved by successful control of blood sugar.  This is an interesting connection to explore further because type 2 diabetes is a disease that can be prevented through lifestyle modification.
  • Herpes Simplex Virus
  • Allergies: Allergens may result in the release of histamines that result in an allergic reaction that affects nerve conduction resulting in hypersensitivity of the nerves.
  • Circulatory problems:   Circulation problems could cause infarct in the TN.
  • Shingles

According to Katsuhiro Toda, “Tumor or MS alone may be sufficient to cause TN,  whereas neurovascular compression alone, or combined with other minor factors, does not appear  to cause TN.”

Other less well documented, but possible contributors to TN are:

  • Cell phone use:  It was reported at the 2015 IEE 15th Mediterranean Microwave Symposium that a trigeminal nerve tumor may have been caused by cell phone radiation in a worker that made heavy use of the cell phone in close proximity to his ear.  Given this connection it may be advisable for patients with TN to be careful with cell phone use and other sources of microwaves such as WiFi and microwave ovens.  Shutting off wireless routers when not in use may also be beneficial.
  • Diet:  The Standard American Diet (SAD) is related to many illnesses and diseases.  Switching to a healthy vegan or low saturated fat diet often helps with overall health and there have been reports of remission of TN symptoms. A person with TN should take extra care in consuming processed foods that may contain excitotoxic ingredients.  Proper hydration is also critical for optimum body function.  Consult with a dietitian.
  • Sedantary lifestyle:  Moderate to intense cardiovascular exercise helps to improve circulation, capillary density, number of mitochondria and immune function. Consult with your doctor prior to making changes related to physical fitness.

Pleading the 5th

The 5th cranial nerve may be causing you intolerable pain.  As mentioned above there are many possible causes and a doctor’s advice is essential to teasing out your individual situation.  However, keep in mind that not all doctors are up to speed on the latest research.  For example there is much recent research on the power of intermittent energy restriction (intermittent fasting) to trigger the release of brain derived neurotrophic factors (BDNFs) that could play an important role in the healing of brain and nerve disorders.  Many times aggressive treatments such as surgery work for a while but may bring about other complications.  Other less aggressive treatments such as acupuncture, meditation, or yoga may provide sufficient relief for some people.  In consultation with your doctor, it may be worth exploring the lifestyle and environmental alternatives that give your body a chance to heal naturally.

The Overcoming Multiple Sclerosis website has an informative YouTube video (below) that may be beneficial for some people with TN.

And remember that October 7th is International Trigeminal Neuralgia Awareness Day.  Click the link and sign the petition to request that the World Health Organization add Trigeminal Neuralgia to their “Health Topics” list.

May the Fifth be with you.

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