DEAR DR. DONOHUE: I have trigeminal neuralgia. I thought it was a tooth problem and saw an oral surgeon. He said the pain came from a nerve in my face, and he gave me the diagnosis. What kind of medicine can I take for it? – L.T.

ANSWER: You mean the doctor left you dangling in the air with a diagnosis only? There is a lot that can be done for this. Get to a neurologist or a neurosurgeon right away.

The trigeminal nerve is a facial nerve that has two functions: It controls chewing muscles, and it brings sensations from the face to the brain. In trigeminal neuralgia, the sensation function has gone awry.

The misfiring nerve causes attacks of unbearable facial pain that can last from seconds to minutes. Even though the attacks are short, they can come back at any time, and an affected person is constantly on pins and needles waiting to be stabbed in the face with another occurrence. A light touch to the cheek, chewing, brushing the teeth or washing the face can bring on a painful spasm.

Sometimes the problem arises from an artery that encircles the nerve. Pulsations of the artery press on the nerve to initiate an attack. When this is the case, a neurosurgeon can insert a sponge between the encircling artery and the nerve to cushion artery pulsations.

In other instances, medicines can control attacks. Carbamazepine, gabapentin and baclofen are examples.

Destroying the pain-carrying fibers of the trigeminal nerve is another approved treatment. That can be done by injecting the nerve fibers with glycerol or by destroying them with radio-frequency current.

I have given you only a sample of things that can be done for you. You must see a neurologist or a neurosurgeon for proper treatment. The Trigeminal Neuralgia Association can provide you with more information at its Web site: www.tna-support.org.

DEAR DR. DONOHUE: I am 78, and a recent echocardiogram shows that I have mild stenosis of a heart valve. What is stenosis of a valve? Can it be treated with medicine or surgery? Will it worsen or bring on a stroke or heart attack? Would exercise or diet help me? – N.E.

ANSWER: The heart has four valves that keep blood moving from one chamber to the next and eventually out of the heart in an orderly sequence. Defective heart valves either leak blood back into the chamber from which it came – regurgitation – or obstruct flow from one chamber to the next because of narrowing – stenosis.

I am guessing you have a narrowed aortic valve, the valve that keeps blood from running back into the heart after it has been pumped out into the aorta, the body’s largest artery. Many things cause narrowing, aging being one of them.

At age 78, if the narrowed valve is not causing any symptoms and if it’s not disturbing the flow of blood, then it can be left alone. I trust both are true in your case. Your doctor has not told you otherwise.

Symptoms of a significantly narrowed aortic valve include chest pain upon exertion, fainting spells and breathlessness when active.

There is no diet that will expand a narrowed valve, nor are there any exercises for it. Medicines can ease symptoms, but the curative treatment is surgical replacement of the valve – something you are unlikely ever to need.

DEAR DR. DONOHUE: My son recently had a pulmonary embolism. He has been on Coumadin ever since. His embolism was caused by a genetic condition. What is going on? – L.B.

ANSWER: A pulmonary embolism is a blood clot in the lungs. Most often, such clots come from a larger clot in a deep vein in the legs. Your son’s clot came about because he has a genetic problem that causes him to form clots when he shouldn’t. An example of such a condition is a deficiency of proteins C and S, two proteins that prevent unregulated clot formation. It’s a genetic defect that might not manifest itself until later in life. Keeping the blood thin prevents clots from arising. Now that this has been discovered, danger to your son has been eliminated.

DEAR DR. DONOHUE: My husband forgets everything. Is there a way I can check him for Alzheimer’s? – K.R.

ANSWER: Have your husband draw the outline of a circular clock. Then tell him to add the hands of the clock at a time specified by you, say 9:20. The clock test is a reliable indicator of mental function.

A second test is for you to give the names of three items out loud. Let three minutes pass and ask your husband to repeat those items. I must admit, when testing, I write down the items so I remember what I said.

Any mistake on the clock test indicates that mental processing is not at peak performance.

Recalling just one of the three cited items gives a person a passing grade for brain function.

There is no test that identifies Alzheimer’s with certitude, but an evaluation by a trained professional carries much more weight than home tests in predicting the presence of Alzheimer’s disease. What will you do if your husband fails these tests? My point is that it would save you time and possible error to have the family doctor evaluate your husband.

The Alzheimer’s pamphlet discusses this devastating disease more fully. Readers can obtain a copy by writing: Dr. Donohue – No. 903, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.