As noted, TN for MS is different than non-MS TN. The first thing they wanted me to do was rule out that the problem is a dental problem (infection, root canal). After that, I started Gabopentin (Nuerontin). Am now at 600mg x 3 daily. The pain varies, from like a tooth ache, to severe burning of my left face, forehead to jaw. It's always on the left side of my face (hence Trigeminal Nueralgia, the Trigeminal nerve is for the entire face). I also use an herb called Mullein (commonly available). Between the Nuerontin and Mullien, it's pretty well managed. Still some lower jaw pain periodically, but NOTHING like the burning. I drive and do most actives OK (it takes time to get used to Nuerontin -- generic name Gabopentin). If Neurontin doesn't work, the next step is Tegrotol (seizure medication) which has some side effects. God bless!

Great question, for one there are two types of true TN, typical and atypical. In TN its caused by an artery wrapping/coming in direct contact with a nerve.

In MS it's usually because of demylenation often in the brainstem in the area where the trigeminal nerve root exits or somewhere in the trigeminal pathway. So its a different process and stands to reason that the way it feels is somewhat different than traditional TN. Often its on both sides of the face. Mine has layers. It started as numbness at first, didn't get painful for several months. Given that its more like neuropathy than pain. But it has contant numbness, layer on a buring, achy sensation in certain areas and then layered on top of that are that paroxysms ie waves of severe pain. First episode involved sharp pain inside my ear. Second brainstem relapse a year later it changed to a sensation of a million bee stings inside my mouth, starts on floor, side of tongue then spreads outwardly until gone. The numbness involves both sides of my face including my forhead section with the most intense being around my mouth, tongue numbness and weakness in my jaw muscles when I eat. That whole combination is definitely different than traditional TN. Sometimes this instead is called atypical facial pain, the best term to me is trigeminal neuropathy.

Omg. Me too.

I'm so glad I read this. I have all the "layers" described here but never linked them in my mind to one cause... Now I'm certain I have TN. I get sudden severe "tooth root pain" is how I could best describe it. It travels around the left upper teeth so I know it's not a dental problem or related to any one tooth. I get numbness on my lips/mouth area, then a burning and tingling, then it goes away. When I try to eat, my jaw muscles tire out in under 10 seconds... When I was a kid I would shove 20 pieces of gum in my mouth and chew a giant gob of it until my jaw muscles ached -- that's exactly what this feels like! Except it's happening when I'm just beginning to chew a soft tortilla... So now I actually avoid chewing because it's so exhausting (pathetic!) and instead I drink a lot of smoothies with fiber, berries, electrolytes, bentonite clay, probiotics etc.

I have this. I have felt the shocks but not always. Sometimes numbness sometimes an ache. Sometimes it is extremely severe. Dental work makes it worse. I thought I had an ear infection my inner ear hurts so bad once.