Trigeminal Neuralgia

Causes, Symptoms, Treatments For Trigeminal Neuralgia

Trigeminal neuralgia is a type of intense nerve pain (neuralgia) that strikes the facial area without warning. It can be triggered by such simple, everyday activities as saving, putting on makeup, or even eating and drinking. The touch of a feather or a gentle breeze blowing against your cheek can set it off.

Trigeminal neuralgia attacks happen frequently to some people. The condition usually starts off with short, relatively mild attacks. These attacks can get progressively worse and happen more often.

For some reason, women are affected by trigeminal neuralgia more often than men, and it's also more likely to happen to those who are over 50 years old.

It is also sometimes called tic douloureux

Trigeminal neuralgia causes

Pain comes from the trigeminal nerve, which is responsible for transmitting sensation from your face to your brain. Typically, there is pressure at some point on the nerve, often caused by contact from an artery or vein. Pressure may also come from a tumor, but this happens less often.

Trigeminal neuralgia sometimes appears in those who have multiple sclerosis or a disorders that damage the myelin sheath protecting certain nerves. The myelin sheath is a type of electrical insulation that helps impulses travel along the nerve to the brain.

Symptoms of trigeminal neuralgia

Unlike many other conditions, symptoms of trigeminal neuralgia are generally well defined and relatively specific. They include

• Twinges of pain that occur from time to time in the facial area.
• Severe, sudden pain that feels like an electric shock. Many people who have trigeminal neuralgia describe it as a jabbing or shooting pain.
• Sudden, severe pain that occurs from chewing, speaking, brushing your teeth or almost any type of stimuli that may cause contact between the nerve and the object placing pressure on it.
• Periodic attacks that may continue for weeks or even months.
• Pain that affects one side of the face at a time, or one specific area of the face at a time.
• Attacks that grow more frequent and more intense as time passes.

Trigeminal neuralgia treatments

There are a number of treatments for trigeminal neuralgia that doctors have developed.

Medications are usually the initial step, and they often provide needed relief. They can be used to limit or block the pain signals sent to your brain are the most common initial treatment for trigeminal neuralgia.

A number of anticonvulsants have been used successfully but there can be side effects. Depending on the type your doctor prescribes, these could include dizziness, confusion, drowsiness, double vision and nausea, along with suicidal thoughts and behavior, One type, carbamazepine, can trigger a serious drug reaction in some people.

However, as time passes, medications may not be as effective as treatments for trigeminal neuralgia as they were in the beginning. Your doctor may raise the dosage or try another type of medication.

Antispasticity agents provide another option. These relax your muscles and may be used in combination with anticonvulsants. But they also have potential side effects like confusion, nausea and drowsiness.

If medications aren't effective, your doctor may recommend alcohol injections next. These are a temporary measure but are usually effective because they numb the area of the face where the pain originates. Since alcohol injections don't last, a more permanent solution will be needed.

Surgery is the next likely option. There are several different possibilities.

Micro vascular decompression (MVD) - Blood vessels pressing against the trigeminal nerve are removed or relocated. This procedure has a high success rate.

Glycerol injection - During this procedure, your surgeon injects a small amount of sterile glycerol into an area where the trigeminal nerve divides into three branches. After a few hours, the glycerol damages the trigeminal nerve and blocks pain signals.

Balloon compression - Your doctor uses a tiny, needle-live device near the nerve that's causing the problem. The device includes a small balloon, which is inflated, damaging the nerve and blocking pain signals. People who have this procedure done sometimes later experience facial numbness and difficulty chewing.

Radiofrequency/electric current - This treatment for trigeminal neuralgia uses a heated electrode to target and destroy nerve fibers associated with pain. Most people who have this procedure done experience some facial numbness afterward.

Severing the nerve - This calls for cutting part of the trigeminal nerve at the base of your brain. Since the nerve is cut, your face becomes permanently numb.

Radiation - This is a relatively new procedure. You get a high, focused dose of radiation to the root of the trigeminal nerve. This damages the nerve and eliminates pain. This procedure is done without anesthesia and is painless. Discomfort goes away gradually over the course of several weeks, but sometimes returns.