Trigeminal Neuralgia Explained

Trigeminal neuralgia affects the trigeminal nerve. This nerve carries the sensation from your face to your brain. People with this condition experienced a jolt of extreme pain when there is stimulation (no matter how mild) to the face. Something as simple as brushing your face or brushing your hair out of your face can trigger immense pain. At first, the pain will come in short and mild spurts. However, as time passes, the pain will begin to last longer, occur more frequently, and feel more painful.

Trigeminal neuralgia is more common in women who are over 50 years of age.

The symptoms of this disease are usually concentrated to a sharp pain after stimulation of the face. Many describe their episodes as a shooting and jabbing pain, similar to an electric shock. The pain is triggered from everyday actions such as chewing, speaking, touching of the face, smiling, drinking, talking, encountering a slight breeze, and brushing of the teeth. The pain can last from a few seconds to several minutes. Furthermore, there will always be a constant ache that burns that is less painful the shooting pain. Usually, the pain would affect various parts of the face such as the jaw, lips, teeth, gums, cheek, eyes, and forehead. The pain can either be focused in one area or it can radiate throughout the face.

Trigeminal neuralgia occurs when one’s trigeminal nerve’s function is disrupted. When this happens, the contact between the normal blood vessels and the trigeminal nerve places pressure on the nerve and causes a dysfunction.

This disease is associated with aging, multiple sclerosis, the damaging of the myelin sheath, or the compressing of the trigeminal nerve, brain lesions, brain abnormalities, surgical injuris, stroke, or facial trauma.

Treatment for trigeminal neuralgia usually starts with medications, and for certain individuals, no additional treatment is needed.

However, some people would stop responding or experience negative side effects from these treatments over time. When this occurs, injections or surgery would be the next option. Medications for this disorder could be carbamazepine such as Tegretol and Carbatrol that are generally very effective to treat the pain associated with trigeminal neuralgia. Other anticonvulsant drugs would include oxacarbazepin (Trileptal), phenytonin (Dilantin and Phenytek), and lamotrigine (Lamictal). If these anticonvulsant start to lose it’s effectiveness, the doctor may switch the patient to a different medication.

Muscle-relaxing agents such as baclofen (Gablofen and Lioresal) may be used alongside the anticonvulsant. Botox injections can also be used to reduced pain. However, there is not a lot of research and studies that support. Surgery can also be an option. The goal of trigeminal neuralgia surgery is to stop the blood vessels from compressing the trigeminal nerve prevent the nerve from getting damaged.

Damage to the nerve can result in temporary or permanent facial numbness. Even with these surgical procedures, the pain can return years or even months later. Surgery options include mincrovascular decompression, Gamma Knife radiosurgery, and glycerol injection. Microvascular decompression is when you relocate or remove blood vessels that are in contact with the trigeminal root.

Gamma Knife radiosurgery involves a dose of radiation directly to the root of the trigeminal nerve. This procedure will damage the trigeminal nerve and minimize or eliminate the pain. A glycerol injection is when the doctor inserts a needle into the base of the skull. The needle will be  inserted in the trigeminal cistern. The trigeminal cistern is a small sack of spinal fluid that would envelope the trigeminal nerve ganglion. The injection of sterile will damage the trigeminal nerve and block the pan signals. However, many people would experience reoccurrence later on, facial numbness and tingling.

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