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TIC DOULOUREUX and cannabis studies completed

Tic Doulourreux (Trigeminal neuralgia) (TN, or TGN), also known as Prosopalgia, or

Fothergill's disease is a neuropathic disorder characterized by episodes of intense pain in the face, originating from the trigeminal nerve.

It has been described as among the most painful conditions known to mankind and therefore has been sometimes labeled the 'suicide disease'


Medical Marijuana and Tic Douloureux

source: Marijuanadoctors.com

Tic Douloureux or trigeminal neuralgia is a nerve disorder that affects the face. It is a stand-alone condition (idiopathic tic douloureux) and can also be a symptom of other conditions, such as multiple sclerosis. The symptoms of tic douloureux originate in the trigeminal nerve. Pressure on that nerve can cause the symptoms as well as damage. People who are older are more likely to develop tic douloureux but there is no age group in which it cannot appear. However, it is easier to find the cause of trigeminal neuralgia in sufferers who are under 40 years of age.

There is only one symptom of tic douloureux and that is an electric shock like pain in the face. Any part of the face can be affected, including the eyes. However, it most often affects one side of the face. Tic douloureux can be brought about by audio or physical stimulation. Simple acts such as brushing teeth, shaving, washing the face and kissing can cause pain in tic douloureux sufferers. In some people, it is brief and only occurs occasionally. In others, the pain can be near constant and painful to the point of debilitation.  

Treatment of tic douloureux can include some medications and surgery. In cases where surgery is necessary to relieve the pressure, medical marijuana can help with pain. However, it cannot render surgery unnecessary. Surgery may also be indicated in tic douloureux pain that is resistant to treatment. Nonetheless, medical marijuana is useful as a treatment for neuralgia such as tic douloureux. It can also have several bonus effects in patients with multiple sclerosis who have tic douloureux and other neurological symptoms.

Medical Marijuana and Tic Douloureux

Tic Douloureux and Medical Marijuana Research 

Due to the acceptance of certain medicinal cannabinoids such as Nabilone and Marinol for use against conditions like HIV, AIDS and cancer, there has been a lot of research on nerve pain and medical marijuana, relative to other conditions. That is because these conditions can cause significant nerve pain and trials can be conducted on patients who are receiving the medication for conditions allowed by federal law. As tic douloureux is nerve pain, this research is relevant to trigeminal neuralgia sufferers.

In a study conducted on 523 HIV patients with nerve pain and other symptoms, medical cannabis provided marked relief for a number of symptoms. Ninety-percent of the study participants reported that their nerve pain was reduced by the drug. Muscle pain was also improved in most of the study participants. Tic douloureux sufferers often report similar results when using medical marijuana. However, most of the relief is subjective and anecdotal. Until proper clinical trials are conducted and relief is observed in blind studies, it is unlikely that tic douloureux will be considered an acceptable condition for medical marijuana treatment by the United States federal government.

Medical Marijuana and Research into Conditions that Cause Tic Douloureux 

The varicella zoster virus, multiple sclerosis, certain tumors and enlarged blood vessels can cause tic douloureux. Medical marijuana can help with tic douloureux caused by anything by treating the pain. However, the research only delves into a few of these conditions. Most of it is conducted on multiple sclerosis and nerve pain in general. 

Oral mucosal cannibinoids are a medical marijuana that is prescribed in Canada for treatment of multiple sclerosis pain. Like Nabilone and Marinol in the U.S., its acceptance as a treatment for multiple sclerosis nerve pain, including tic douloureux, came about only after numerous trials and studies proved its efficacy on a number of patients. Like virtually all medications, it does not work for every patient. However, it provides significant relief for some, which is good news for individuals with chronic pain caused by tic douloureux. 

Tic douloureux caused by a tumor may require a number of treatments, some of them invasive. In non-cancerous tumors, removal of the tumor or other surgery to relieve pressure and pain is sometimes indicated. Treatment like chemotherapy may also be necessary to fight the cancer. Medical marijuana can help patients with non-cancerous tumors causing tic douloureux by helping relieve pain. It can help patients with cancerous tumors causing tic douloureux relieve nerve pain and it can help treat the side effects of chemotherapy if it becomes necessary during treatment.

Tic Douloureux – Cannabis

by Jan

TIC DOULOUREUX-Cannabis

Trigeminal neuralgia (TN),  tic douloureux  (also known as prosopalgia,  the Suicide Disease or Fothergill's disease) is a neuropathic disorder characterized by episodes of intense pain in the face, originating from the trigeminal nerve.  One, two, or all three branches of the nerve may be affected.  It is "one of the most painful conditions known to humans,  yet remains an enigma to many health professionals."   This pain may be felt in the ear, eye, lips, nose, scalp, forehead, cheeks, teeth, and/or jaw and side of the face;  some patients also experience pain in their left index finger.  Trigeminal neuralgia (TN) is not easily controlled but can be managed with a variety of treatment options.  It is estimated that 1 in 15,000 people suffer from trigeminal neuralgia,  although the actual figure may be significantly higher due to frequent misdiagnosis. In a majority of cases, TN symptoms begin appearing after the age of 50,  although there have been cases with patients being as young as three years of age.  It is more common in females than males.


The disorder is characterized by episodes of intense facial pain that last from a few seconds to several minutes or hours.  The episodes of intense pain may occur suddenly.  To describe the pain sensation, patients may describe a trigger area on the face so sensitive that touching or even air currents can trigger an episode;  however, in many patients the pain is generated spontaneously without any apparent stimulation. It affects lifestyle as it can be triggered by common activities such as eating, talking, shaving and brushing teeth.  Wind, high pitched sounds, loud noises such as concerts or crowds, chewing, and talking can aggravate the condition in many patients.  The attacks are said by those affected to feel like stabbing electric shocks, burning, pressing, crushing, exploding or shooting pain that becomes intractable.


Individual attacks usually affect one side of the face at a time, lasting from several seconds to a few minutes and repeat up to hundreds of times throughout the day.  The pain also tends to occur in cycles with remissions lasting months or even years.  10-12% of cases are bilateral, or occurring on both sides.  This normally indicates problems with both trigeminal nerves since one serves strictly the left side of the face and the other serves the right side.  Pain attacks are known to worsen in frequency or severity over time, in some patients.  Many patients develop the pain in one branch, then over years the pain will travel through the other nerve branches.


Outwardly visible signs of TN can sometimes be seen in males who may deliberately miss an area of their face when shaving,  in order to avoid triggering an episode.  Successive recurrences are incapacitating and the dread of provoking an attack may make sufferers unable to engage in normal daily activities.


Some patients report continuous pain or continuous pain during waking hours;  for reasons that are not yet known, TN sufferers rarely have pain attacks or are awoken due to pain while they are sleeping.  In fact, most patients have a very brief window of reprieve upon awakening from sleep, though that window can sometimes last only minutes.  The mechanisms as to why one feels no pain while they are asleep, or in a slumber state, even though a pillow may be in contact with a "trigger point" on one's face, remains a mystery to physicians and dentists.

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This type of injury may rarely be caused by an aneurysm (an outpouching of a blood vessel); by a tumor; by an arachnoid cyst in the cerebellopontine angle;  or by a traumatic event such as a car accident or even a tongue piercing.
Any of the three branches of the nerve may be affected.  Neuralgia of the first branch results in pain around the eyes and over the forehead;  of the second branch, pain in the upper lip, nose, and cheek;  of the third branch, pain on the side of the tongue and the lower lip.


Causes and Risk Factors of Tic Douloureux


The cause is unknown, but the disorder occurs most frequently in middle and later life.
It affects women more frequently than men.


Symptoms of Tic Douloureux


The pain may be a tearing, darting, or sharp cutting sensation that occurs in a portion of the face, typically on one side.  An attack may last for seconds or a few minutes, and its intensity may make one contract the facial muscles, hence the term tic.  Episodes may recur for days or weeks or months.


Often, there are trigger zones - spots on the face or certain movements - that precipitate the pain.  These may include smiling, talking, chewing, brushing one's teeth, or blowing the nose.  Although the pain may be incapacitating, it is not life-threatening. Attacks come and go variably, but periods of remission may grow shorter as one ages.


Because it is easy to mistake the pain for a toothache, people suffering from trigeminal neuralgia often consult a dentist.  The result in many cases is inappropriate and often irreversible treatment, including tooth extraction, splints to readjust the jaw position, and root canal surgery.

 

Symptom Treatment

There are many unusual diseases that do not respond well to conventional medicines.  TN is one of these.

There is always intense body pain. Vaporized cannabis gets into the system the fastest!  It takes Marinol a full hour to reach full system effect. However, a cannabis extract taken orally is my best recommendation.  (20 mg. of THC is stronger than 120 mg. of Codeine).  CBD protects nerve cells and acts as an anti-oxidant. THC and CBD together  treat pain. Cannabichromene (CBC) is an anti-inflammatory that contributes to the pain killing effects of cannabis.  

Better to use the whole plant extract rather than use a synthetic of either. Repeat every four (4) hours as needed.  There has never been a documented THC overdose (fatality). The effective dose of THC is at least 1,000 times lower than the estimated lethal dose. 1,500 pounds of cannabis would have to be smoked in under fourteen (14) minutes to overdose. Daily dosage of cannabis: vaporized or taken orally stops the symptoms of Tic Douloureux.

Sativas have  elevated cannabidiols-showing greater immune enhancing abilities, more stimulating psychological effects.

Indicas have elevated cannabinols-showing more narcotic effects, stronger pain relievers and relaxing  effects.

Best Strain:  William's Wonder. Because of the terrible head pain with this disorder, Any Sativa X hybrid (sativa x indica) hybrid.

Resources:

1.   Alison Myrden.  Her recommendation for TN symptom relief.

2.  Marijuana Handbook:  Practical Guide to Therapeutic Use of Marijuana.  Gieringer, Rosenthal, Carter.

3.  Lester Grinspoon, MD

4.  Ethan Russo, MD

5.  Tod Mikuriya, MD

6.  National Institute of Mental Health

7.  United Kingdom Medicinal Cannabis Research Foundation

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Images Trigeminal nerve

The trigeminal nerve (the fifth cranial nerve, also called the fifth nerve, or simply CNV) is a nerve responsible for sensation in the face and certain motor functions such as biting and chewing. It is the largest of the cranial nerves. Its name ("trigeminal" = tri- or three, and -geminus or twin, or thrice twinned) derives from the fact that each trigeminal nerve, one on each side of the pons, has three major branches: the ophthalmic nerve, the maxillary nerve, and the mandibular nerve. The ophthalmic and maxillary nerves are purely sensory. The mandibular nerve has both cutaneous and motor functions.

Sensory information from the face and body is processed by parallel pathways in the central nervous system. The motor division of the trigeminal nerve is derived from the basal plate of the embryonic pons, while the sensory division originates from the cranial neural crest.

 The sensory function of the trigeminal nerve is to provide the tactile, proprioceptive, and nociceptive afference of the face and mouth. The motor function activates the muscles of mastication, the tensor tympani, tensor veli palatini, mylohyoid, and anterior belly of the digastric.

source: expedia

 

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What Is Tic Douloureux?

Tic Douloureux or trigeminal neuralgia is a nerve disorder that affects the face. It is a stand-alone condition (idiopathic tic douloureux) and can also be a symptom of other conditions, such as multiple sclerosis. The symptoms of tic douloureux originate in the trigeminal nerve. Pressure on that nerve can cause the symptoms as well as damage. People who are older are more likely to develop tic douloureux but there is no age group in which it cannot appear. However, it is easier to find the cause of trigeminal neuralgia in sufferers who are under 40 years of age.

There is only one symptom of tic douloureux and that is an electric shock like pain in the face. Any part of the face can be affected, including the eyes. However, it most often affects one side of the face. Tic douloureux can be brought about by audio or physical stimulation. Simple acts such as brushing teeth, shaving, washing the face and kissing can cause pain in tic douloureux sufferers. In some people, it is brief and only occurs occasionally. In others, the pain can be near constant and painful to the point of debilitation.  

Treatment of tic douloureux can include some medications and surgery. In cases where surgery is necessary to relieve the pressure, medical marijuana can help with pain. However, it cannot render surgery unnecessary. Surgery may also be indicated in tic douloureux pain that is resistant to treatment. Nonetheless, medical marijuana is useful as a treatment for neuralgia such as tic douloureux. It can also have several bonus effects in patients with multiple sclerosis who have tic douloureux and other neurological symptoms.

Medical Marijuana and Tic Douloureux

Tic Douloureux and Medical Marijuana Research 

Due to the acceptance of certain medicinal cannabinoids such as Nabilone and Marinol for use against conditions like HIV, AIDS and cancer, there has been a lot of research on nerve pain and medical marijuana, relative to other conditions. That is because these conditions can cause significant nerve pain and trials can be conducted on patients who are receiving the medication for conditions allowed by federal law. As tic douloureux is nerve pain, this research is relevant to trigeminal neuralgia sufferers.

In a study conducted on 523 HIV patients with nerve pain and other symptoms, medical cannabis provided marked relief for a number of symptoms. Ninety-percent of the study participants reported that their nerve pain was reduced by the drug. Muscle pain was also improved in most of the study participants. Tic douloureux sufferers often report similar results when using medical marijuana. However, most of the relief is subjective and anecdotal. Until proper clinical trials are conducted and relief is observed in blind studies, it is unlikely that tic douloureux will be considered an acceptable condition for medical marijuana treatment by the United States federal government.

Medical Marijuana and Research into Conditions that Cause Tic Douloureux 

The varicella zoster virus, multiple sclerosis, certain tumors and enlarged blood vessels can cause tic douloureux. Medical marijuana can help with tic douloureux caused by anything by treating the pain. However, the research only delves into a few of these conditions. Most of it is conducted on multiple sclerosis and nerve pain in general. 

Oral mucosal cannibinoids are a medical marijuana that is prescribed in Canada for treatment of multiple sclerosis pain. Like Nabilone and Marinol in the U.S., its acceptance as a treatment for multiple sclerosis nerve pain, including tic douloureux, came about only after numerous trials and studies proved its efficacy on a number of patients. Like virtually all medications, it does not work for every patient. However, it provides significant relief for some, which is good news for individuals with chronic pain caused by tic douloureux. 

Tic douloureux caused by a tumor may require a number of treatments, some of them invasive. In non-cancerous tumors, removal of the tumor or other surgery to relieve pressure and pain is sometimes indicated. Treatment like chemotherapy may also be necessary to fight the cancer. Medical marijuana can help patients with non-cancerous tumors causing tic douloureux by helping relieve pain. It can help patients with cancerous tumors causing tic douloureux relieve nerve pain and it can help treat the side effects of chemotherapy if it becomes necessary during treatment.

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Video - What is Trigeminal Neuralgia? Symptoms, Causes, Treatments

 *NOTE - This website published this video to give you a better view from a specialist to understand this condition. For a list of the side effects from pharmaceutical medications mentioned in this video please click here and search for the medication's chemical composition.

Dr. Neil Martin, M.D., FAANS Chairman of the Department of Neurosurgery at UCLA and Director of the Aneurysm and AVM Program, discusses the latest updates in trigeminal neuralgia treatments.

Visit http://neurosurgery.ucla.edu to learn more about trigeminal neuralgia treatments at UCLA.

About Neil A. Martin, M.D.

Neil A. Martin is Chairman of Neurosurgery and the W. Eugene Stern Professor in Neurosurgery at the David Geffen School of Medicine at UCLA. As Neurovascular Director of the UCLA Stroke Center, and Director of the Aneurysm and Arteriovenous Malformation (AVM) Program, Dr. Martin is a preeminent neurosurgeon world renowned for his unique expertise in AVM, aneurysm, and stroke. He is highly sought after by media and peers around the globe and to speak about groundbreaking treatments and research for vascular diseases and disorders.

Dr. Martin is often featured as an expert on CNN, ABC, National Public Radio, in the Los Angeles Times and makes regular appearances on the national CBS show "The Doctors." Learn more about Dr. Martin at http://uclahealth.org/NeilMartin.

 

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Therapeutic potential of cannabinoids in trigeminal neuralgia.

Abstract

Trigeminal neuralgia is a disorder of paroxysmal and severely disabling facial pain and continues to be a real therapeutic challenge to the clinicians. While the exact cause and pathology of this disorder is uncertain, it is thought that trigeminal neuralgia caused by irritation of the trigeminal nerve. This irritation results from damage due to the change in the blood vessels, the presence of a tumor or other lesions that cause the compression of the trigeminal root.

The pain of trigeminal neuralgia is characterized by unilateral pain attacks that start abruptly and last for varying periods of time from minutes to hours. The quality of pain is usually sharp, stabbing, lancinating, and burning. The attacks are initiated by mild stimuli such as light touch of the skin, eating, chewing, washing the face, brushing the teeth, and exposure to wind. Although antiepileptic drug therapy may be beneficial in the treatment of trigeminal neuralgia, up to one-half of the patients become refractory or intolerant to these medications. At present there are few other effective drugs. In cases of lacking effect after pharmacotherapy, surgical options may be considered.

Currently there is growing amount of evidence to suggest that the psychoactive ingredient in cannabis and individual cannabinoids may be effective in alleviating neuropathic pain and hyperalgesia. Evidence suggests that cannabinoids may prove useful in pain modulation by inhibiting neuronal transmission in pain pathways.

Considering the pronounced antinociceptive effects produced by cannabinoids, they may be a promising therapeutic approach for the clinical management of trigeminal neuralgia.

 

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