The Nerve – It’s a Pain in the Face

Dr. Dharani Mudugal, a headache neurologist, and Dr. Melvin Field, a neurosurgeon, join The Nerve to talk about what changes when a patient with facial pain is treated by a team rather than a single physician. In this episode, they discuss why so many facial pain diagnoses turn out to be something other than trigeminal neuralgia, how to make sense of the competing classification systems patients encounter, the medications used before surgery is considered, what to expect if you’re traveling for treatment, and how the field has changed over the last 20 years.
This episode includes discussion of the severity of facial pain, including its emotional toll. If you or someone you know is struggling, the 988 Suicide & Crisis Lifeline is available 24/7 by calling or texting 988 in the US.

In this episode, host Liam Winters sits down with Ramona, whose journey with trigeminal neuralgia began in 2018 with small electric shocks while brushing her teeth — and turned into nearly two years of misdiagnosis and costly dental work before an observant periodontist pointed her toward a neurologist and an answer.
Ramona shares what the pain really felt like, how she managed treatment costs without dental insurance, the surgery at Mayo Clinic that has left her pain-free for nearly two years, and the letter she now hands to dental professionals so the next patient with unexplained facial pain gets answers sooner.
A note for listeners: Ramona briefly discusses experiencing suicidal thoughts during her most difficult period. If you or someone you know is struggling, free, confidential support is available 24/7 — call or text 988. For more resources, visit FacePain.org.

Dr. Rushna Ali, a neurosurgeon at the Mayo Clinic, returns to The Nerve after her popular webinar on neuromodulation, the use of electrical stimulation to block or alter pain signals when other treatments fall short. In this episode, she talks about her journey into functional neurosurgery, how she approaches complex facial pain cases, the state of research and funding, barriers to accessing care, and what she'd tell someone newly diagnosed with trigeminal neuralgia.

In Part 2 of this two-part episode, host Liam Winters continues his conversation with neurosurgeon Dr. Michael Brisman, neurologist Dr. Ivan Mikolaenko, and radiation oncologist Dr. Leester Wu.
Picking up where they left off, the panel dives deeper into the management and treatment of trigeminal neuralgia, further exploring the medical and procedural options available to patients, how to manage treatment side effects, and how patients can find treatment options near them.

Welcome to The Nerve, a podcast dedicated to exploring issues related to neuropathic facial pain. In this episode, host Liam Winters, the FPA's Manager of Development and Professional Outreach, is joined by three specialists in facial pain care: Dr. Michael Brisman, a neurosurgeon with NSPC Brain & Spine Surgery in Rockville Centre, NY; Dr. Ivan Mikolaenko, a neurologist in Brooklyn, NY; and Dr. Leester Wu, a radiation oncologist with Mount Sinai South Nassau in Oceanside, NY.
 
A couple of months ago, the three of them joined the Facial Pain Association for a live webinar on developments in the management and treatment of trigeminal neuralgia, and we received so many thoughtful questions from our audience that we wanted to bring them back for a deeper conversation. In Part 1 of this two-part episode, the panel explores how trigeminal neuralgia is diagnosed and the range of medical and procedural treatments available to patients.  

Welcome to The Nerve, a podcast dedicated to exploring issues related to neuropathic facial pain. Hosted by Brandi Underwood, the FPA's Manager of Development, Research, and Advocacy, this episode discusses the power of advocacy and features an engaging conversation with Anna Williams, a patient advocate.
Anna shares her journey from living with facial pain to becoming an active leader in the advocacy community. Together, Brandi and Anna discuss their experience joining over 250 volunteer advocates from across the country on Capitol Hill in support of common-sense legislative priorities as part of the Alliance for Headache Disorders Advocacy & The Headache Alliance's Headache on the Hill.
Join us as we explore Anna's journey to advocacy and the critical issues facing those with facial pain, offering insights into the essential role that personal stories and advocacy play in bringing about meaningful change.
You can learn more about how to take action on the legislative priorities discussed during this webinar by visiting this link: https://forms.allianceforheadacheadvocacy.org/a/take-action-support-headache-hill-2025-legislative-agenda
You can also learn more about the 2025 FPA In-Person Conference on  June 7-8, 2025 in Minneapolis Minnesota and register today by visiting www.FacePain.org.  

Welcome to The Nerve, a podcast brought to you by the Facial Pain Association, dedicated to exploring all aspects of neuropathic facial pain. In this episode, host Brandi Underwood introduces a panel of experts from Noema Pharma who discuss the latest advancements in treating trigeminal neuralgia through the Libra study. Learn about the innovative trial design, patient involvement, and the investigational medication, NOE-101. The discussion delves into patient experiences and the collaborative efforts necessary to bring new hope and effective treatments to those suffering from facial pain.
This episode also guides listeners on how to participate in the trial and emphasizes the importance of patient-centered research. For more information and resources, visit FacePain.org.
For a deeper dive into the study, you can watch the full webinar, which includes a Q&A session with audience questions answered by the experts at https://youtu.be/kkpBrLtvzA8?
 
Disclaimer
The Facial Pain Association (FPA) is enthusiastic about medical research and encourages those with neuropathic facial pain, including trigeminal neuralgia, and related healthcare conditions to consider participation. It is important to note, however, that the FPA is not offering, nor is it qualified to offer, a scientific or medical endorsement of any Institutional Review Board (IRB) approved patient study.
An IRB is a committee established to review and approve research involving human subjects. The purpose of the IRB is to ensure that all human subject research is conducted in accordance with all federal, institutional, and ethical guidelines. All studies and trials listed have IRB or Ethics Committee approval where relevant. The study's safety and scientific validity is the sole responsibility of the study sponsors and investigators. Patients should use the contact information provided to contact the research organization for more information.Choosing to participate in a study is an important personal decision. Before you participate in a study, discuss all options with your healthcare provider. Although study sponsors may donate to the FPA, or support the FPA through advertising or corporate sponsorship, such support does not influence or guide our decision about the studies we identify.Noema Pharma is a sponsor of the Facial Pain Association.

Welcome to The Nerve – It’s a Pain in the Face. A podcast dedicated to covering all topics relevant to neuropathic facial pain. Hosted by the Facial Pain Association, our mission is to provide a platform that informs, empowers, and connects individuals within the facial pain community. Whether you are a person living with facial pain, a caregiver, or a healthcare professional, join us as we delve into the world of neuropathic facial pain.
"The Nerve" is not just a podcast—it's a lifeline for those affected by neuropathic facial pain. We are here to meet you where you are, offering a compassionate and informative space to navigate the challenges and triumphs of living with facial pain. You will hear the stories of people living with these conditions, including young patients. You will learn about the latest treatment developments and research from experts in the field. You will add more tools to your toolbox as we face facial pain together.