You don’t anticipate experiencing severe, shock-like pain while performing a routine task like brushing your teeth or intense burning on your left cheek while washing your face. On the other hand, trigeminal neuralgia sufferers may have similar experiences frequently. Because it affects the trigeminal nerve, it gets its name. In addition to transmitting sensation from the face to the brain, the trigeminal nerve controls some motor abilities, including swallowing, biting, and chewing.
Introduction to trigeminal neuralgia
Another name for trigeminal neuralgia (TN) is Tic Douloureux. The most terrible, agonizing, rapid, and intense pain that a person can experience is terminal neuralgia. It occurs on one side of the face in brief spasms and bursts of pain that may be followed by multiple of these episodes. There may be tingling or numbness prior to the episodes starting. Pain flare-ups can be brought on by minor facial contact, such as when shaving, applying makeup, cleaning teeth, or washing one’s face. The vibrations produced by eating, drinking, talking, or even a light breeze can cause pain to flare up. There might be times when there is no pain at all, and these remission periods could last for days, months, or even years. Women and people over 50 are more likely to experience trigeminal neuralgia. This disorder could be hereditary.
When the trigeminal nerve is damaged or injured, it can result in trigeminal neuralgia. A tumor (abnormal outgrowth of cells) or pressure from a blood vessel pressing on the trigeminal nerve root could cause it. It may also happen if the trigeminal nerve’s sheath is harmed or destroyed. Trigeminal nerve damage can occur in certain diseases, such as Multiple Sclerosis (an inflammatory condition of the nerve sheaths), usually in the later stages of the disease.
Trigeminal nerve injury can result from infections or from any type of facial or dental surgery. Rarely, TN may be inherited and run in certain families.
While trigeminal neuralgia can affect anyone, the following individuals may be more susceptible to developing it.
- People above the age of 50
- Women
- Having a case of trigeminal neuralgia running in your family
Diagnosis and tests
The type of pain that is felt is the main factor used to diagnose terminal neuralgia. The doctor might inquire as to whether the pain is sudden, intense, and excruciating, as well as which area of the face is impacted. The doctor can determine which trigeminal nerve is affected with the use of these details. Additional information would also be required, such as whether the pain is merely due to touch or if it is brought on by vibrations from everyday activities like eating, drinking, swallowing, brushing one’s teeth, or wind.
It might be necessary to perform the following tests in order to confirm the diagnosis:
Facial examination: To find out if any trigeminal nerve branches are affected, the doctor may touch and examine different areas of your face.
Magnetic resonance imaging (MRI): Instruments which use magnetic field may be used to scan if your trigeminal nerve or its branches are injured or damaged.
If your doctor suspects that a tumor is the cause of your trigeminal nerve injury, they may order additional specialized tests for you to undergo.
Treating trigeminal neuralgia
The initial option of treatment is medications. Most people respond to these medications. However, these medications may lose their effectiveness or develop unwanted side effects over time. Surgery and other procedures are among the other treatment options available for such conditions.
The purpose of medications is to obstruct the signals that reach the brain. Anticonvulsants, antispasmodics, and antidepressants are medications that lessen seizures, spasms, and pain sensitivity, respectively. Any of these drugs may be prescribed by your physician. It is possible for your doctor to recommend a mix of medications. To relieve excruciating trigeminal nerve pain, your physician might recommend alcohol injections to numb the affected area and obstruct the nerve.
Reducing the pressure from blood vessels on the trigeminal nerve or fixing any damage to the nerve could be the objective of the surgical option. The surgical procedures include:
Gamma knife radiosurgery (GKR): In order to treat TN, gamma rays—high frequency electromagnetic radiation—are applied to the trigeminal nerve. The process doesn’t hurt and doesn’t require anesthesia. Loss of facial sensation may occur in less than 5% of patients.
Microvascular decompression: The blood vessel putting pressure on the trigeminal nerve is removed during the procedure. To access the damaged portion of the trigeminal nerve and either re-route or remove the blood vessel responsible for the injury, your doctor might perform a surgical incision behind your ear. To relieve pressure on the trigeminal nerve, the surgeon may position a pad between the nerve and the blood vessel.
Glycerol injection: To render the trigeminal nerve insensitive to pain, an injection of glycerol may also be given to its base. Loss of facial sensation could follow this procedure, and TN could return.
Balloon compression: The trigeminal nerve is made insensitive to signals by the surgeon inserting a balloon through a catheter to the base of the nerve, preventing the patient from feeling pain. Some people may lose sensation in part or all of their faces.
Rhizotomy (Severing the nerve): To render the trigeminal nerve or any of its branches incapacitated, the surgeon may choose to partially severe the nerve at its base. The patient may never regain sensation in their faces due to the irreversible damage.
Living pain free
Trigeminal neuralgia can affect your daily life by causing extreme pain when performing even simple activities like brushing and talking. It can hamper your work productivity and your social interactions. Finding support groups may be a good bet as it provides understanding and encouragement.
