This excellent article by one of our members provides an alternative look at TN and its treatment. It is well documented, fully footnoted and has an excellent bibliography (for further study) It raises some excellent questions for all of us. The full title is:
To MVD or not to MVD? Trigeminal Neuralgia – A cervicogenic model.
The classification of head and facial pain is constantly evolving and by its nature incomplete, with various bodies from institutions, to the IASP to the IHS playing their part.
Whilst a classification system is useful in facilitating, communication between
doctor/doctor/patient, diagnosis, treatment and treatment outcomes, it can also be detrimental. Many patients’ symptoms don't fit a particular box yet this is where they are placed, boxed in, and consequently on a treatment protocol that fits that box.
For example, in a rigid box system of classification, the migraine patient who goes on to develop Trigeminal like pain finds themselves in two boxes with two different treatment protocols and as such the possibility that the two have a single cause is often ignored to the detriment of the patient and future research into the patient's condition.
I use migraine as a possible example but the same could be said of various head and face pain conditions; TMJ, occipital neuralgia, atypical odontalgia, Type2 TN,GN, GPN to name but a few.
Head and facial pain disorders as such are not immune to junk diagnoses due to presenting and often overlapping symptoms. Put simply Trigeminal Neuralgia means pain in the distribution of the nerve with no more
meaning than the term sciatica, it is not a diagnosis but a description of symptoms which is why the pathogenesis (be it microvascular compression or other) of TN remains a hypothesis, and is open to debate. A diagnosis of Trigeminal Neuralgia may as well mean Tough Nut to crack. For the purpose of this article therefore TN can be read as “TN like” pain.
The entire article can be found in this PDFTN7.pdf