TMJ issues causing cranial nerve compression? - TMJ Disorder -TemporoMandibular Joint Message Board

pipdog · 05-27-2009, 12:59 PM

Does anybody know if there is a connection between trigeminal neuralgia and TMJ/occlusional issues?

I'm in a quandary but may just be starting to make sense of my problem

Pre-molar extraction as a teenager
Braces
result over closed bite and squished up jaw joints (on the scan they look like shepherds crooks)

I'm in a neuromuscular orthotic which has given me a better bite but I still have left sided pain. The only thing which really helps reduce this is holding my jaw down and forward so I'm thinking this must be the key to the whole problem.

Unfortunately I'm not Sherlock Holmes and need help

I looked at anatomy diagrams and the top of the jaw joint is at the same level as the base of the brain exactly where the trigemeninal nerve exits the brain stem. Most specialists now believe the shooting pain of neuralgia is caused by a blood vessel compressing the nerve at this point and there is a surgical proceadure to separate the two with a teflon sponge. I've seen a neurosurgeon and he says I have a clear 'vascular conflict' at the root entry zone of the left trigeminal nerve and that I am a candidate for the surgery. Trouble is it involves drilling open the skull behind the ear and going into the brain stem so I'm like whoa I need to make SURE first of all that this is a) the correct diagnosis and b) that there isn't someother way of fixing it

Is holding the jaw down and forward in effect decompressing this very tight area and taking the pressure off the nerve by giving the vessel more room?

I get the feeling that its some kind of weird hybrid deal falling between neurosurgery and orthodontics.

Can anybody relate?

luvtocamp · 05-27-2009, 02:23 PM

The pain of trigeminal neuralgia occurs almost exclusively in the maxillary and mandibular divisions- this is what I read.

the trigeminal nerve has several branches and has a long path so the problem could be compression anywhere along the nerve brach, even from muscular tension.

sometimes it can go away on its own, and is usually on one side of the face .

I would make sure to try everything else before surgery. I sometimes fear this may be what I have as I have MS, but I don't think its the ms.

I am having NCR soon and I'll post on the results.

PS: i wanted to add that most of my muscle spasms and pain have been on the right side, but I got new dentures not long ago, and I got major spasms on both sides of the face a, so I just want to say that I think the bite has alot to do with this. You can always have the surgery done, I don't know your history how long you've been dealing with this, but I hate to see you have surgery and still have the same problems.

Have you tried a upper cervical chiro, or some mild neck traction from a pt, and how is your posture?

Thelma-Louise · 05-27-2009, 06:15 PM

You raise a vaild issue Pipdog - I am under the impression that many of my symptoms or medical condtions I have been diagnosed with (dystonia, myofacial pain and spasms, fibro, myclonic muscle jerking, dyskinesia, etc) are all related even if they are in themselves separate and distinct medical condtions. My hands are often numb and tingly which I know for certain is a compression of a nerve somewhere in my neck and while pinched nerves can be surgically corrected I doubt I will ever do so as to me that is only addressing a secondary or resulting consequence of the real problem - yet to be indentified and correctly treated.

The fact that holding your jaw down and forward helps you I believe is key - this would imply you have lost some vertical dimension along the temporal plane and could account for the compression along the trimengial nerve pathway. Have you looked into the Gelb appliance which supposedly addresses this issue and is designed to bring the jaw down and forward? Is that what Dr Stack (didn't you see him at one point?) tried with you?

I would be hesitant of any type of surgical intervention regarding any nerve within the body - its not so much the surgery itself as it is the results that warrants hesitation - any time you sever or interefere with a nerve you are running the risk of permanent damage and other adverse affects - I would certainly leave this as a last resort.

StillHope · 05-27-2009, 11:05 PM

Please, do not do any surgery unless it is the very last resource after all else has been exhaused.
Even dentists say that it should be this way!
T-L is right: this nerve can be compressed by anything in the jaw and muscles.