What is Trigeminal Neuralgia?
Trigeminal neuralgia is a rare disorder that causes persistent pain on your face. This disorder affects the trigeminal nerve that runs from your brain to the face. The area where this nerve passes on your face is seriously affected causing excruciating pain. The pain attack can be sudden (acute) or gradual and chronic. Trigeminal nerve runs across cheeks, jaw, forehead and ears and hence even touching of these areas of your face would cause severe pain.
Some people complain of having intense pain when they touch their face for simple reasons like brushing their teeth or to apply makeup. Slight stimulation of the face would cause staggering pain due to trigeminal neuralgia. This disorder largely affects old people and more women are affected with this problem than men. At present pain can be effectively managed by proper medications and other therapy.
Trigeminal Nerve :
Trigeminal nerve is collection of three main nerves located on your face. The root of this nerve is found in your brain and it splits into three sub nerves which would subsequently divide into many branches. The first main nerve passes from the skull into your forehead and eyes. The second nerve passes through the cheeks on both side and the third nerve would enter the jaw region. Hence any disruption in this nerve branches would cause severe pain on these regions.
Intense persistent pain on the face is the only symptom of trigeminal neuralgia. This disorder can cause sudden shooting pain that feels like an electric shock. Even touching any part of your face can cause shooting pain. Trigeminal neuralgia can cause episodes of shooting pain, sudden acute pain (lasting for few seconds), chronic attacks of pain lasting for several days and sometimes pain on particular spot of the face. There are few fortunate people who would have no symptoms for months together and sudden onset of intense pain.
The intensity of pain may range from mild to severe. Again for some people pain would be felt occasionally and for some there would be persistent pain. The area where the trigeminal nerve passes on your face are worst affected by pain. Often intense pain is felt on one side of your face and for some people, pain is restricted only on certain areas like cheeks or jaw but for others, pain is felt on the entire face. Over time, the intensity of pain would increase disturbing the quality of life.
The normal function of trigeminal nerve gets interrupted causing intense pain of trigeminal neuralgia. But what exactly triggers and disrupts its function is not known. It is believed when any artery or vein on your face touches with the trigeminal nerve can cause sudden acute pain. If accidentally, any artery of your face coincides with the trigeminal nerve, extra force is created on it leading to severe pain.
People having multiple sclerosis disorder have high risk of developing TN since the protective layer (myelin sheath) of trigeminal nerve get disturbed due to sclerosis. Brain tumor can also cause excruciating pain of trigeminal neuralgia. Certain triggering factors like shaving, eating, drinking and brushing your teeth can start pain. For some people, draft of a breeze or a small smile is enough to trigger the pain.
Who are at risk?
Elderly people (above 55 or 60 years) and more particularly elderly women are more prone to develop trigeminal neuralgia than others. One cannot predict exactly when the episodes of pain would occur. For some people pain would be felt occasionally and for some it can cause persistent pain. The pain may last from few seconds to few minutes.
Trigeminal neuralgia can interfere with your routine activities and even you may lose quality of sleep due to chronic pain.
No separate tests are needed to diagnose trigeminal neuralgia. He would gently touch your face to check for pain. He may order for reflex tests and if required, do CT scanning.
Painkillers are the first line option for treating trigeminal neuralgia. Taking painkiller drugs for long duration can produce side effects. You can manage mild pain by taking Ibuprofen or any other similar medications over the counter. Your doctor may prescribe carbamazepine or tegretol or other anticonvulsant drugs to reduce pain. Initially small doses of drugs are given and gradually your doctor may increase the strength of medications according to the intensity of pain.
Taking these drugs for long can cause unwanted effects. Antispasmodic drugs like gablofen or lioresal are given in combination with anticonvulsant medications to get the best possible effect to manage pain. For people for whom medications are ineffective, deep brain stimulation can be done in which electrical pulse is sent directly to particular spot of the brain that controls the trigeminal nerve.
Images, Pics, Photos and Pictures of Trigeminal Neuralgia :
It is the last option for trigeminal neuralgia. Decompression surgery is done by making tiny incision behind the ear region. The skull is drilled opened and any artery or vein overlapping the trigeminal nerve is removed. Your doctor will decide whether you are suitable candidate for surgery after considering your age, health and intensity of pain.
Gamma knife surgery is a process in which beam of radiation is passed on the trigeminal nerve directly to block its function. The sensors of that nerve will not communicate any pressure to the brain and hence pain would not be felt anymore. When compared with surgery, this process is better option. Glycerol injection can also be used to block the function of trigeminal nerve.
Artificial pressure is created on the trigeminal nerve by balloon compression method. Your surgeon would insert a small tube into your skull which is then passed inside to locate the right nerve. Now a balloon is sent inside through the catheter which would be inflated through the other end. The force produced by inflation of balloon is sufficient to block the trigeminal nerve.