12/17/07 #1 - The relationship between migraines and trigeminal neuralgia?

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Full Question:

I am curious about the relationship between migraines and trigeminal neuralgia. My father had terrible headaches in his 30s-40s, and developed TN in his 60s-70s. I developed migraines in my 30s, am now 44 and starting to feel tingling in my face like early TN along with ever worsening migraines. I've researched TN and found that it's caused by an overactive nerve at the center of the brain. Could that also be related to migraines? The medications prescribed for both are anticonvulsants, and Botox is now being tried for both on an experimental basis. This can't be a coincidence. What is the relationship? And can one medication address both issues, or is that too much to expect? Cathy.


Dear Cathy;

While trigeminal neuralgia and Migraines can coexist and certainly Migraines can be strongly familial, the two clinical conditions coexisting faithfully and multiple generations is quite unusual. It turns out that the trigeminal nerve nuclei and the brainstem are involved in (mis)processing of painful signals arriving there. As far as Botox, we have had success with Migraines, trigeminal neuralgia, temporomandibular dysfunction, and other facial pain problems that relate to the trigeminal nerve system. I think a single medication can help both clinical situations but it would be a skillful pharmacologist who could engineer that for you. Search out your best headache and face pain specialist near where you live.

Good luck on your quest for relief,
John Claude Krusz and Teri Robert

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