Acute Shock Trigeminal Neuralgia Pain Left Side of Face; Will TENS therapy help?

Female over 65. Random shocks of acute severe pain only on left side of face. Most severe around inner side of left eye extending down left side of nose to upper lip.
Acute electrical shock like pain lasts 30 seconds to one minute. Up to 5 attacks per day.
Left eye reddens and tears, lower eye lid swells. Left side of upper lip swells.
Triggered by:
Rubbing left side of face, washing face.
Blowing nose, sneezing.
Eating some spicy foods. Sucking on hard candy touching roof of mouth on left side.
These symptoms most closely match those of Trigeminal Neuralgia.
Occipital Neuralgia is also a possibility, however the pain attacks are not in the neck or back of head.

Both conditions are relatively rare, but more common in women over 50 years of age.

These attacks started about 5 years ago.
Dental exam and x-rays show no infection or decay.
ENT: Deviated Septum surgery was done but did not relieve the problem.
MRI showed one possibility; demyelination of the occipital nerve on the left side rear of neck.

Medications: She did not respond to Indomethacin. Carbamazepine (Tegretol) was not recommended due to the patient being Asian with high risk factor for damage to skin and internal organs. A nerve block injection at the occipital nerve seemed to work for awhile, but the attacks have returned. PT for stretching and strengthening neck and shoulders was also done.

We have read of positive results for pain management using a TENS unit in clinical settings.
Small (1") pads are used, one on the effected side of the face just in front of the ear, and the other above or below the eye on the effected side of the face. A constant high frequency (>50Hz to 150Hz) was used with a low pulse rate at an intensity below motor contraction. I don’t see any consumer grade TENS units where you can set the pulse rate (frequency Hz) or the pulse width time period.

My comparison of consumer TENS machines has coincidentally led me to the same recommendation as you, the iRelieve 8080. Do you think the iRelieve 8080 is safe for treatment of trigeminal neuralgia?
I see in your videos where you don’t recommend using it on head or eyes.

Thanks for any advice.

Consult an ophthalmologist. Almost certainly not temporal arteritis, but because the eye is involved, they may have seen this before. (the Hopkins Wilmer clinic used to turn up all sorts of interesting non-eye problems that had symptoms that involved the eye. Ditto the dermatology clinic, when diseases involve dermatologic symptoms)

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Thanks for your reply. I should have mentioned she sees an opthalmologist regularly and he does not see any issues that would be causing these attacks. So we did our due diligence ruling out dental, optical and ENT issues.

A neurologist has examined her and his diagnosis is 'acute or chronic paroxysmal hemicrania, which is more of a medical definition of her symptoms than it is a diagnosis. Paroxysmal means ‘sudden attack’ and hemicrania means ‘pain on one side of the head’. He feels that it is a result of demyelination of the occipital nerve near the base of the skull rear left side which is also near the facial nerve. Her symptoms most closely match Trigeminal Neuralgia symptoms.

Anyhow, when I asked him about TENS therapy, he said TENS has shown to help manage this type of pain, similar to acupuncture. I also forgot to mention she also tried acupuncture about the time of the nerve block and PT and then the attacks went into remission for awhile. So we aren’t sure what caused things to calm down, the nerve block, PT, acupuncture or all three. The PT she has been doing on her own, but it’s inconvenient and getting expensive to get acupuncture treatments 3 times a week and getting an appointment for a nerve block takes several weeks.

So, we really aren’t looking for help with a diagnosis, just asking for advice on the use of a TENS machine for facial pain management. Something we can do from home.

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TENS has been used in the treatment of Trigeminal Neuralgia. A medical professional should be consulted in person and oversee the use at least initially.