Trigeminal neuralgia: the serial killer inside your own face

I'm not gonna lie, this past month has SUCKED. First I had the carnival of oral surgery, which I thought would be a breeze and most assuredly was NOT but then last week I was visited by the trigeminal nerve fairy.

I'd heard of the trigeminal nerve since I was a biology major but reading about it in a textbook while preparing for a test on cranial nerves is far different than suddenly being afflicted by trigeminal neuralgia.

What is a neuralgia? It's a fancy way of saying "nerve pain." Trigeminal neuralgia describes the trigeminal nerve, one of the cranial nerves serving the face:

Source

So, trigeminal neuralgia basically means "lightning bolt inside your fucking face."

Originally saved here.

According to the American Association of Neurological Surgeons, "Trigeminal neuralgia, also known as tic douloureux, sometimes is described as the most excruciating pain known to humanity."

Trigeminal Neuralgia:
Kicking ass and being recognized for this by NEUROSURGEONS

What is "tic douloureux"? Oh, it's a fancy French word for "wince." You know the way you might wince if a serial killer was stabbing you? Same thing, except the stabber is invisible.

I was thinking about this. When we watch movies, you may see someone stabbed or branded with a hot cattle iron or a struck by a lightning bolt. You see them wince and fall to the ground. But the cause is obvious so no one is like "bro, what just happened? You're weird!"

But if you're standing on line at the supermarket and a trigeminal neuralgia attack strikes, no one can SEE it. It feels LIKE a stabbing, so there'll be all that wincing and body part grabbing, the way you would if you wanted to contain the innards behind whatever had been slashed open, but in reality, you're standing on this slow line and nothing bad is happening in the world so no one can tell why you're having a personal emergency.

The disease is also apparently known as "suicide disease" because you wish for death rather than bear it. I would never have fully understood this before experiencing it.

Luckily, medicine helps, and I'm on an anti-epileptic medicine (despite not having epilepsy), because "sodium-channel inhibitors" inhibit neural activity and the goal is to reduce the transmissions of electrical impulses hitting the trigeminal nerve from the brain.

Realistic photo after "neural activity" is reduced... 

The mild side effects are grogginess and dizziness, which I hope get a little better by the time I have to go to work next week.

One thought about where trigeminal neuralgia comes from is that since the nerve originates in the brain stem, a blood vessel may bump up against it and over time, wear away the insulatory outer sheath or myelin.

How does trigeminal neuralgia manifest? It really does feel like being stabbed. The sensations last a few seconds to a few minutes. (Unless you have the "atypical" kind and it's constant.) You're fine, until the pain hits, a 10 on a 10 scale. Or maybe a 20 on a scale of 1-10. It's unbearable.

One of the symptoms (among severe "lancinating" or stabbing pain) is "anxiety at the thought of the pain returning."

DUDE, entire MOVIES have been made based on the fear of the serial killer returning. Hollywood is FULL of them.

Having trigeminal neuralgia is like having a little serial killer sitting on your shoulder and they just stab your face when they feel like it.

It can be multiple times in a minute, or maybe one time in an hour. You just don't know. And when you go to sleep, the little serial killer hangs out with you, sometimes stabbing you out of sleep. Someone make a movie of THAT. Last night was the first time in 4 nights I actually GOT sleep because the medicine worked (it seems like it takes a little while to fully kick in). So as you can see, it's been great.

Why can't I just get the flu like normal people???

-- That time I fell asleep typing and then sold my notes

I once had a special gig in school where I got paid to write up my notes for Intro to Microbiology. There were two outfits in town that paid students for notes and one said, “Well, we don’t normally hire the same note-taker as the other place because it’s good for students to have a variety to choose from, but no one else stepped up so the gig is yours if you want it.” 

I was broke at the time and working two other jobs but I appreciated the side hustle. It happened to be the worst semester of my entire life. I had just moved to the area and everything was so much more expensive. I was the most sleep-deprived I'd ever been (well maybe except for the time I was a counselor at a sleepaway camp, which should really be called “awake-away camp," but I digress.)

One night I was up until the wee hours typing up my notes and I fell asleep right in the middle of typing. 

Sitting up. 

My head didn't loll, my fingers didn't fall away from the keys, my shoulders and arms didn't drop. I just kept typing. I fell asleep typing, woke up typing, and continued to type until I was done. I never realized I had fallen asleep. I never re-read the notes so I never saw the evidence that I was out cold for a few straight minutes.

The next day, I handed my notes in, got paid and went on my merry way.

Months pass. 

The night before the final, I pulled out my notes to study and saw the following:

1. Transformation
2. Conjugation
3. Transduction
   
   artificial protoplanst. Fusion and electro poradion and gun & micro injection. Profus kindks memeebrane stick and DNA transfer, elec open pores in cell sideface, gene gun -- coat projectile w/DNA & shot into cell. & hiccp injection pucure cell walls.
   
   Know the basis of how genes are transferred (figure 9.16, pg. 261 for example).

I typed this?

How did I not realize I'd fallen asleep? What was I trying to say??

2am and I just discovered (along with 299 other poor slobs from class) that an entire concept was useless!

I still have no idea what this was about. But I owe a few hundred students a beer!