Trigeminal Neuralgia: Opportunities for Research and Treatment

Workshop Summary

Held: September 14, 1999

Organizer: Cheryl A. Kitt, Ph.D., NINDS

Sponsors: NINDS, NIDCR, NIH Office on Rare Diseases, NIH Pain Research Consortium

---

 

Background

Trigeminal neuralgia is a condition that affects the trigeminal nerve; it is characterized by a sudden, severe, electric shock-like or stabbing pain typically felt on one side of the jaw or cheek. The disorder is more common in women than in men and rarely affects anyone younger than 50. The attacks of pain, which generally last several seconds and may be repeated one after the other, may be triggered by talking, brushing teeth, touching the face, chewing, or swallowing. The attacks may come and go throughout the day and last for days, weeks, or months at a time, and then disappear for months or years.

top

---

 

Summary

This small workshop focused on understanding the current status of research on this condition, and to identify new avenues of research and collaborations that would have an impact on this disorder as well as on other painful conditions that may be due to injury or disease.

The workshop brought together basic scientists (both extramural and intramural), neurologists, neurosurgeons, NIH program directors from the NIH Pain Consortium, and representatives from the patient advocacy group The Trigeminal Neuralgia Association, to identify priority areas for future directions in basic and clinical research in Trigeminal Neuralgia, specifically, and neuropathic pain in general.

Following an overview of the clinical picture of Trigeminal Neuralgia and a patient presentation, the talks covered the following topical areas: status of clinical trials/medications for Trigeminal Neuralgia; epidemiology; diagnostic criteria; role of gender; mechanisms of pain and plasticity; translational research; treatment strategies; and genetics.

top

---

 

Recommendations

Several key areas were identified as priorities for setting a research agenda on Trigeminal Neuralgia:

• Epidemiology
• Pilot Clinical Trials of Medications (i.e., new anticonvulsants; transmitter receptor- or ion channel-specific drugs)
• New Model Systems for Pain (including in vitro and in vivo models)
• Research Opportunities in Humans (including imaging; electrophysiology; anatomy, circuitry, and systems approaches)
• Mechanistic Studies of Pain (i.e., neural plasticity)
• Identification of Non-Neuronal Mechanisms (i.e., vasculature; immune system; myelin)
• Diagnostic Criteria
• Evaluation of the Efficacy of Medical versus Surgical Treatments
• Infrastructure Mechanisms for Collaborations, Education, Patient Registry, etc.

top

---

Follow-up:

• A referenced summary report has been prepared for publication in the journal Pain. (see Referenced Summary Report)
• A Request for Applications to stimulate research in Trigeminal Neuralgia and other painful neuropathies is also being considered.

Invited Participants

Gerald D. Fischbach, MD
Director
NINDS
Bldg. 31/8A52
Bethesda, MD 20892
Phone: (301) 496-9746
email: gf33n@nih.gov

Harold C. Slavkin, D.D.S.
Director
NIDCR
Bldg. 31/2C39
Bethesda, MD 20892
Phone: (301) 496-3571
email: hs73u@nih.gov

Clifford J. Woolf, MD, Ph.D.
Anesthesia-Neural Plasticity Res. Group
Massachusetts Gen. Hosp.
149 13th St
Rm 4309
Charlestown, MA 02129-2000
Phone: (617) 724-3622
Fax: (617) 724-3632
email: woolf.clifford@mgh.harvard.edu

Jeffrey S Mogil, Ph.D.
Dept Psychol.
Univ. Illinois At Urbana-
Champaign
603 E Daniel St
Champaign, IL 61820
Phone: 217-333-6546
Fax: 217-244-5876
email: jmogil@s.psych.uiuc.edu

W. Crawford Clark, Ph.D.
Research Foundation for Mental Hygiene
New York State Psychiatric Institute
1051 Riverside Drive
New York, NY 10032
Phone: 212-543-5480
Fax: 212-543-6012
Email: clark@iris.rfmh.org

Linda LeResche, Sc.D.
Dept. of Oral Biology
University of Washington
Box 356370
Seattle, WA 98195
Phone: 206-616-6049
Fax: 206-685-8412
e-mail: LERESCHE@U.WASHINGTON.EDU

Christian Stohler, DDS
Depart. of Biologic and Materials Science
School of Dentistry
University of Michigan
BMS 3218
Ann Arbor, MI 48109-1078
Phone: 734-763-5280
Fax: 734-647-2110
Email: csto@umich.edu

Jon D. Levine, MD, Ph.D.
Div Neurosci/NIH Pain Ctr
Univ. California San Francisco
C-522/Box 0440
521 Parnassus Ave
San Francisco, CA 94143-0440
Phone: 415-476-5108
Fax: 415-476-6305
email: levine@itsa.ucsf.edu

Peter J Jannetta, MD
Dept Neurological Surgery
Univ. Pittsburgh Sch Med
Pittsburgh, PA 15261
Phone: 412-647-0991
Fax: 412-647-0989
email: jannetta@neuronet.pitt.edu

MA Ruda, PHD
Pain & Neurosensory Mechanisms Branch
NIH-NIDCR
Bldg. 49, Rm 1A 11
Bethesda, MD 20892
Phone: 301-402-4980
Fax: 301-402-0667
email: ruda@yoda.nidr.nih.gov

Ian Gilron, MD
Pain & Neurosensory Mechanisms Branch
NIH-NIDCR
Bldg. 10, Rm. 3C434
Bethesda, MD 20892
Phone: 301-496-5483
Email: Igilron@dir.nidcr.nih.gov

Thomas K Baumann, Ph.D.
Div Neurosurgery L-472
Oregon Hlth Sci Univ.
Dept Neurological Surgery
3181 SW Sam Jackson Park Rd
Portland, OR 97201-3098
Phone: 503-494-4985
Fax: 503-494-7161
email: BAUMANNT@OHSU.EDU

top

Conference Organizers

Cheryl A. Kitt, Ph.D.
Program Director for Pain
NINDS
6001 Executive Blvd.
Rockville, MD 20892
Phone: (301) 496-9964
Fax: (301) 402-2060
Email: ck82j@nih.gov

Kenneth Gruber, Ph.D.
Chief, Chronic Diseases Branch
NIDCR
Room 4AN-18C
45 Center Drive
Bethesda, MD 20892-6401
Phone: (301) 594-4836
Fax: (301) 480-8318
Email: kg37m@nih.gov

top

Conference Attendees

David Borsook, MD
MGH NMR Ctr.
Bldg. 149 13th St.
Mail Code 149 2301
Charlestown, MA 02129-2060
Phone: 617-726-3332
Fax: 617-724-2719
Email: DBORSOOK@BICS.BWH.HARVARD.EDU

Marian Emr
NINDS
Bldg. 31/8A06
Bethesda, MD 20892
Phone: 301-496-5924
Email: me20t@nih.gov

Paul Girolami
NINDS
Bldg. 31/8A06
Bethesda, MD 20892
Phone: 301-496-5924
Email: pg100b@nih.gov

Paul Scott, Ph.D.
NINDS
Bldg. 31/8A03
Bethesda, MD 20892
Phone: 301-505-7760
Fax: 301- 480-9172
Email: ps199u@nih.gov

Claudette Varricchio, RN, Ph.D.
NCI
EPN/300
Rockville, MD 20892
Phone: 301-496-8541
Fax: 301-496-8667
Email: cv9h@nih.gov

Judy Finkelstein, Ph.D.
NIA
GW/3C07
7201 Wisconsin Ave.
Bethesda, MD 20892
Phone: 301-496-9350
Fax: 301-496-1494
Email: jf119k@nih.gov

Michael Iadarola, Ph.D.
NIDCR
Bldg. 49/1A11
Bethesda, MD 20892
Phone: 301-496-2758
Email: mi1z@nih.gov

Mitchell Max, MD
NIDCR
Bldg. 10/3C405
Phone: 301-496-5483 x405
Email: mm77k@nih.gov

Richard Gracely, Ph.D.
NIDCR
Bldg. 10/1N-103
Bethesda, MD 20892
Phone: 301-496-5238
Fax: 301-496-1005
Email: rg7w@nih.gov

Raymond Dionne, D.D.S.
NIDCR
Bldg. 10/1N103
Bethesda, MD 20892
Phone: 301-496-0294
Email: rd35s@nih.gov

Margaret Jacobs
NINDS
6001 Executive Blvd.
Rockville, MD 20892
Phone: 301-496-1917
Email: mj22o@nih.gov

Ursula Wesselmann, MD
Johns Hopkins Hosp.
Traylor 604
720 Rutland Ave.
Baltimore, MD 21287
Phone: 410-614-8840
Fax: 410-955-9826
Email: pain@welchlink.welch.jhu.edu

Daniel R. Kenshalo, Ph.D.
NIH
CSR
6701 Rockledge Drive
Bethesda, MD 20892
Phone: 301-435-1255
Fax: 301-480-4181
Email: kenshald@csr.nih.gov

Claire Patterson
President
Trigeminal Neuralgia Association
P.O. Box 340
Barnegat Light, NJ 08006
Phone: 609- 361-6250
Fax: 609- 361-0982
Email: tna@csionline.net

Plus 6 Board Members of the Trigeminal Neuralgia Association