Vaginitis/Vaginal
Discharge
(Leucorrhea - Dai Xia)

Written by Chris Eddy

Trigeminal neuralgia (TN, or TGN) also know as tic douloureux is a severe neuropathic chronic pain disorder affecting
the trigeminal nerve (also known as the fifth cranial nerve: a three-branched nerve that carries sensations from the face to the brain and controls facial motor functions such as biting and chewing).

The classic presentation of TN (type 1) is characterized by episodes of sudden, explosive severe pain along the trigeminal nerve, with periods of pain-free remission between attacks.

This disorder is characterized by episodes of intense facial pain along the trigeminal nerve divisions.

The trigeminal nerve is a paired cranial nerve that has three major branches: the ophthalmic nerve (V1), the maxillary nerve (V2), and the mandibular nerve (V3). One, two, or all three branches of the nerve may be affected. Trigeminal neuralgia most commonly involves the middle branch (the maxillary nerve or V2) and lower branch (mandibular nerve or V3) of the trigeminal nerve.

(TN) commonly occurs when a blood vessel applies pressure to the trigeminal nerve, which spans the face. Characterized by episodes of pain lasting from days to months, Trigeminal neuralgia produces intense flashes of pain that can be triggered by contact with wind, talking, shaving, kissing, brushing the teeth, eating, applying makeup and other tasks that involve contact with the cheek area. These episodes are generally tempered by periods when the individual experiences no pain, however as time progresses, these pain episodes become longer with shorter periods of relief.

Western medical treatment uses drugs such as anti-convulsants and pain killers as front line therapy, followed by surgical decompression in severe and chronic cases.

Chinese Medicine

The trigeminal nerve has 3 branches which come out around the taiyang area of the face. In trigeminal neuralgia the pain can be quite severe with an electrical or burning sensation.

There are 3 common diagnosis related in Chinese medical terms:

  1. Exterior – Wind-Cold Invasion
  2. Interior – LV/ST Fire
  3. Interior – Yin Deficiencyw/empty fire rising

Differentiation:

Wind-Cold Invasion

Signs & Symptoms:

Acute onset, severe pain for a few seconds to a few minutes several times/day

Exterior signs, runny nose, tearing

Tongue: Thin white coat

Pulse: Tight, floating

Treatment Points: GB 14, UB 2, Distal: TH 5, LI 4

LV/ST Fire

Signs & Symptoms:

Severe pain w/irritability, Internal heat signs, thirst, constipation

Tongue: Yellow, dry coat

Pulse: Wiry

Treatment Points: ST 2, SI 18, LI 20, Distal: LI 4

For pain in the mandibular region:

Local: ST 6, ST 7

Extra point 1 cun lateral to CV 24

Distal: LI 4

Wind-Cold: Add GB 20

LV/ST Fire Add LV 3, possibly LV 2, ST 44

Yin Deficiency w/empty heat rising

Signs & Symptoms:

Pain is more insidious, gradual, comes and goes, mallar flush, soreness in lumbar area

Tongue: Red w/no coat

Pulse: Thin, fast

Treatment Points:For pain in the supraorbital region:

Local: ST 2, SI 18, LI 20

Distal: LI 4

For pain in the mandibular region:

Local: ST 6, ST 7

Extra point 1 cun lateral to CV 24

Distal: LI 4, Wind-Cold Add GB 20

LV/ST Fire: Add LV 3, possibly LV 2, ST 44, Yin DeficiencyAdd KD 6, SP 6

Case Study:

A 66-year-old woman was referred with a typical TN pain on the left side of her face for 25 years. She was diagnosed with TN after evaluation and work-up by a neurologist. She used medications, including phenytoin (200 mg per day) and carbamazepine (600 mg per day). The pain was triggered by speaking, eating or touching. The pain was evaluated using a visual analog scale (VAS), which ranged from 0 (no pain) to 10 (worst pain imaginable). According to the VAS, the patient rated her pain as 10.

Protocol and Outcome:

For facial neuralgia, the protocol utilized local points of TH 17 and 21, GB2, SI 18, ST 2, 3 and 7, GV 26 and LI 20; systemic points included TH 5, LI 4, ST 36, ST 44, ST 45 and LIV 3. Auricular acupuncture points were also used (Shen Men, neuro, face and lung points). Needles were not manipulated, and no attempt was made to elicit De-Qi. Every treatment session lasted about forty-five minutes, three times a week. After the fourth session, she reported that she had been relieved almost pain free. By the sixth week (14 sessions), the patient was completely free of pain (VAS = 0) and was still pain free at the end of sixth month.

Personally I find that local points to the face, including laser is not always the best approach.

Correct distal needling and correct diagnosis of the channels affected seems to yield the best results for me.

I found using master Tung’s extra points: Ce San Li (77.23) and Ce Xia San Li (77.23) on the opposite knee to the effected
side of the face, with guiding hand points (on the same side as effected) Ling gu (22.05) Da Bai (22.04) and Zhong Bai (22.06) work best, combined with other points such as Men JIn/St43 for heat aversion and inflammation of the Stomach meridian.

 

About the Author

If you would like to book in to see us, please click HERE for the Melbourne CBD practice, or HERE, for the Northcote practice.

Chris Eddy has over 17 years clinical experience and 7 years lecturing experience at RMIT university.

Chris Eddy

1 thought on “Trigeminal Neuralgia Treated With Acupuncture”

  1. Hello there! My name is Rachael and I believe I have trigeminal neuralgia. Acupuncture has worked really well for me with this but it has come back due to stress and I want more support in how to stop the pain from reoccurring.

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