Clinical Cases

Revisiting: A Case of Trigeminal Neuralgia

Who remembers our trigeminal neuralgia case from last month? Here it is again with the answer to follow.

Time to give the answer to last month’s quiz:

This month, it’s our friend Gabi who came to me with a case.  Here she is now, looking like she’s waiting for a bus. 

Anyway…..It seems her friend, “Mitzi” had a terrible mishap at the dentist — who hasn’t? A nerve was damaged while working on Mitzi’s tooth!  I told Gabi to shoot the “Acute Case Questionnaire” over to her at once, without which, I, as a homeopath, can scarcely help anyone.

So, the case came back as follows:

“Onset–sudden or gradual” and “What was going on at that time?” are irrelevant questions when the case is an injury; so, we move on to our questions about “Sensation, Location and Modalities”. The pain is on the right side of the face. The sensation is like knives, like needles, the pain is shooting; it comes and goes and makes Mitzi so sick she has to lie down. (That would be a modality–better lying down or resting.) She can’t talk; her jaw is “blocked”, she says. Hot compresses make the pain better, another modality.

We come now to “appearance”. The patient looks very sick. The right side of the face can be swollen when in pain for a while.

Her general state–She wants to be alone and is irritable. She cries from the pain and feels desperate and hopeless. She says her thirst hasn’t changed.

Concomitants– She salivates more and her eyes run.

She says the most striking thing about her case is the desperation.


Now, to solve the case!  Put simply, as Vasilis Ghegas used to say–and probably still does–if you have a trigeminal neuralgia, there are two issues: Right side, or left side? Better hot, or better cold?  That’s it!

Right side = Mag-phos.

Left side = Spigilia

Better hot = Mag-phos.

Better cold = Spigilia

So, obviously, I looked up Mag-phos. to see if it covered the case and amazingly, practically the entire case was there! Let’s list the elements of the case:

1. Right-sided facial neuralgia

2. Pains like knives/needles

3. Shooting pain

4. Pains come and go

5. Better lying down

6. Better heat

7. Irritable

8. Better alone

9. Lachrymation

10. Desperate

11. Cries from the pain

12. Jaw is stuck, can’t talk

13. Increased salivation

So, how many of these fit Mag-phos.? Using Murphy’s materia medica (Homeopathic Remedy Guide), we see the following under Mag-phos.:

“Neuralgic pains relieved by warmth…better rest…pains…in paroxysms, compelling her to cry out…sharp, shooting, like lightning, suddenly changing places. Radiating, extorting cries. … always talking about her pains, sobbing, crying, lamenting all the time about pain….”

Under “Face”, we see, “facial neuralgia” and “lock-jaw” (note her comment about her jaw being “blocked”).

Under “Eyes”, we see, “increased lachrymation”.

Under “Mouth”, we see, “painful contraction of jaw joint.”

Under “Comments”, we have, “The pains of Mag-phos. are shooting like lightning….Better warmth. … Nash says Mag-phos. is in the first rank as a pain remedy and has all kinds of pain (though cramping pain is the most characteristic) except burning pains and this distinguishes it from Arsenicum since both are better from heat. … The attacks of pain are attended with great prostration.”

The increased salivation is not mentioned, but, Phosphorus is a 2 for that in the Repertory, so, maybe that’s enough to cover that symptom, but, I have a feeling that this really isn’t part of the case anyway because it’s probably a common symptom of someone with mouth pain or tooth pain to have excessive salivation or just maybe a disinclination to swallow, so, we’re not really concerned about that symptom as much as the others.

Better from being alone isn’t listed, but, if the pain causes prostration and the need to lie down, that would cause her to go off alone to her room, I’m not sure that better alone really applies here; and I think it would probably be common to be irritable under the circumstances too.

A lot of people voted for Hypericum in this case. It was roughly half and half between these two remedies. Of course, Hypericum is a very big remedy for injury to the nerves. But it doesn’t have the important modality in the case:  better warmth.

Now, I’d like to tell you who the winners are, but, on Friday the 13th, my computer crashed! Hopefully I will be able to list the winners’ names in February, but, to be on the safe side, if you guessed Mag-phos. in this quiz, please send me an email and let me know.  Sorry about that!  Be sure to tune in again next month for another fabulous hpathy quiz!


About the author

Elaine Lewis

Elaine Lewis, D.Hom., C.Hom.
Elaine is a passionate homeopath, helping people offline as well as online. Contact her at [email protected]
Elaine is a graduate of Robin Murphy's Hahnemann Academy of North America and author of many articles on homeopathy including her monthly feature in the Hpathy ezine, "The Quiz". Visit her website at: and


  • My daughter just had a brain tumor removed….they say all of it was removed. She still has some pain……..and discomfort from the trama. Would mag Phos help her??


  • If you’ll notice, Mag-phos worked here because the pain matched the symptoms mag-phos causes in overdose. So the question would be, what would be appropriate for your daughter’s post-surgery pain? I would start with Arnica 200C, one dose and see what happens. If there’s incision pain, Staphysagria might also be a good choice. Her case should be taken in the same manner as the one above and then matched to an appropriate remedy with the same or similar symptoms.

  • I had an impacted wisdom tooth pulled a couple of years ago and still have jaw pain on my left side. Have been dealing with “Phantom Toothache” symptoms for about a year and 1/2.
    I have been to countless doctors and dentists, oral surgeons and acupuncture. Still – no answer. Most lean toward TN. My questions is, if the pain is on the left side (lower jaw/ inner ear radiating to collar bone) but is aggravated by cold what approach do I take? Left side = Spigilia Better hot = Mag-phos… Hmmm. Am I a contradiction to the norm?

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