Research team studying genetic component of trigeminal neuralgia molar tooth extraction healing time

A chance conversation at the offices of The CJN marked the first step to her getting relief. Ana was speaking to fellow employee and Ask Ella columnist Ella Burakowski about her mother’s travails and Ella recognized immediately what she was going through. It was the same type of pain she herself experienced many years ago.

When she was first stricken with trigeminal neuralgia in 1992, Burakowski experienced pain similar to what Abrahamyan went through. “It’s like being shocked with an electric prod,” she said. It could be brought on by brushing the teeth, touching the cheek or just having a meal.

Burakowski too approached her cousin, an endodontist, and asked him to remove her teeth. He could find nothing wrong with them and wouldn’t do it. A trip to a gum specialist didn’t help and after a time she was referred to a facial pain clinic at Mount Sinai Hospital.

Ze’ev Seltzer knows what those suffering with trigeminal neuralgia are going through. A professor of genetics at the University of Toronto, Seltzer is part of an international team studying the illness. The project is headed by Dr. Marshall Devor, a Toronto native who is laboratory head and former chair of the Department of Cell and Development Biology at the Institute of Life Sciences at the Hebrew University and who founded the school’s Center for Research on Pain. It is funded by the Facial Pain Research Foundation.

In recent years, thanks to new imaging techniques, researchers have come to learn that 16 per cent of the population “have the congenital abnormality in which a blood vessel compresses on the nerve root,” causing the condition, Seltzer said.

Researchers are investigating why only a small portion of that group actually suffer the excruciating pain, while most don’t, he continued. They think there’s a genetic reason for it, a gene or group of genes which predisposes some to experience the pain while others don’t.

While there are currently treatments available, none are foolproof. Medication works, but it has nasty side effects. Vascular decompression surgery doesn’t work for everybody while another surgery, which cuts the nerve, “leaves the face completely numb and sometimes even this doesn’t work,” Seltzer said.

Burakowski maxed out at 1200 mgs of Tegretol (Abrahamyan takes 800) but after 13 years, it stopped working. Even while on the drug, she hated the side effects. It made her sleepy and “you can’t get out your words. It’s nicknamed the stupid drug,” she said.

Recording her experiences online and later on Facebook, she learned there were thousands just like her, going through the vagaries of the disease. She still updates her status on the anniversary of her operation, which has kept her pain free for nine years.

Not all surgeries work so well or last much longer than 10 years, said Seltzer. That’s why an effort is needed to find a more permanent cure for the illness. The race is on to find the genes in question. When they do, it’s likely not just trigeminal neuralgia patients who will benefit.

The team is collecting a patient database of 500 trigeminal neuralgia sufferers in 10 or 11 medical centres. They are hopeful to have located the gene or genes in question within 10 years and develop a pharmacogenomic solution to it, said Seltzer, adding that the costs of the study are substantial. Contributions are always welcome.