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I have had terrible pain and aching in the sideJointPain Hack Reviewof face for about four years. Thinking it was my teeth, I spent a fortune at the dentist, but it made no difference. The doctor says that it's ‘trigeminal neuralgia'. I'm on a drug called carbemazepine but I still have days when it hurts just to talk or wash. It can also hurt round my eyes, which become red and puffy underneath. Have you any suggestions, please?

I get many letters about this debilitating problem, which I am sure your doctor has diagnosed correctly, Neuralgia refers to nerves. Cords of nerves, bundled, up in fibres surrounded by a protective sheath, run with messages from the central nervous system (the brain and spinal cord) to the muscles, skin and other body organs. Twelve pairs of cranial nerves come from the brain. Sensory nerves pick up touch, pressure, vibration, heat, cold and pain, as well as vision, taste, smell and hearing. Motor cranial nerves carry out the movements of the facial, eye, tongue, swallowing and speech muscles, and of the diaphragm.

The fifth and largest cranial nerve is a mixed nerve, called trigeminal because it has three branches. The top one supplies the upper part of the face, the middle one goes to the cheeks, nose and upper lip, and the lower one to the mouth, teeth, tongue and lower jaw. If the trigeminal nerve malfunctions, it can cause sensory problems including pain or motor complications such as difficulty chewing. Tic douloureux is a painful facial spasm that may occur with trigeminal neuralgia. The nerves are so sensitive that the tic can be triggered by a light touch, strong breeze, even a movement. Each attack can last for several minutes to several hours. The pain is so intense that some people opt to have the nerve surgically destroyed and face the prospect of a numb mouth, rather than more attacks.

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