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Trigeminal neuralgia is a disorder that is also known as tic douloureux. It is a facial pain syndrome that can cause excruciating pain, sometimes recurrent and sometimes chronic. It is usually localized to one side of the face in the lower face and jaw. It can sometimes radiate to areas around the nose or above the eye.
In this blog post, we discuss the symptoms, causes, diagnosis and treatment of Trigeminal Neuralgia.
Shooting pain is the most common symptom of Trigeminal Neuralgia. Most patients describe it as an electric shock or a stabbing sensation. The pain can vary in intensity.
People with Trigeminal Neuralgia describe the pain as "the most painful feeling of humankind." Women have stated it is worse than childbirth.
Trigeminal Neuralgia is usually recurrent and can be difficult to predict when an attack will occur. This can be stressful for the patient because they don't know when the next episode will come.
Some people can identify triggers such as brushing their teeth or even smiling, but pain can also occur for no reason. Patients with Trigeminal Neuralgia can be mindful of their triggers to help with managing attacks, but sometimes pain can come without any warning. It also can be very frustrating because some triggers, such as eating or brushing your teeth, cannot be avoided.
Patients may only experience pain for a few seconds, while for others, it can last for a few minutes. Unfortunately, with time, the episodes can last longer if left untreated.
Although actual attacks may only last a few seconds or minutes, some patients feel a less intense dull, aching, consistent pain. The pain can be chronic and feel like a muscle spasm. It can be even harder to deal with than spontaneous attacks, as there is little relief.
Trigeminal Neuralgia can affect other areas of the face. Some patients experience pain in both sides of the cheeks. Others experience pain in their jaw, affecting chewing and eating. Some patients even experience pain in their teeth or gums.
Less frequently, pain can be felt in the lips, under the nose, in the eyes, or on the forehead.
A disruption in the trigeminal nerve causes Trigeminal Neuralgia. Usually, pressure is placed on the nerve when there is contact between a normal blood vessel (typically an artery or vein) and the trigeminal nerve at the base of the brain.
There are other causes as well. Sometimes the condition is related to multiple sclerosis or other disorders that damage the myelin sheath that protect nerves. Trigeminal Neuralgia can also be caused by a tumor compressing the nerve.
A doctor will perform a physical exam based on the pain you are experiencing. They will discuss the type of pain, location, and triggers.
A doctor may perform a neurological exam. This will involve touching and examining your face to determine where the pain is occurring and reflex tests to determine if another condition or a compressed nerve causes the symptoms.
An MRI can also be ordered to determine if multiple sclerosis or a tumor is causing the condition.
Treatment usually is effective with medications. Most often, anti-convulsant medications are used. Carbamazepine is usually the most effective medication for treating Trigeminal Neuralgia. Other medications that can be used include oxcarbazepine, Lamictal, or gabapentin.
Muscle relaxants and botox treatments are also options that are sometimes effective in treating the condition.
Surgery is an opinion for patients with Trigeminal Neuralgia. This can include microvascular decompression and brain stereotactic radiosurgery (Gamma Knife).
Microvascular decompression involves relocating or removing the blood vessels that come into contact with the trigeminal root. This stops the nerve from malfunctioning.
With the gamma knife procedure, the surgeon uses radiation focused on the root of the trigeminal nerve by damaging the nerve; it reduces or eliminates the pain caused by TN.
There are other procedures used known as a rhizotomy. With this type of procedure, the surgeon destroys the nerve fibers to reduce pain.
Your surgeon will discuss with you what the best options are for your specific condition so you can have the best possible outcome.
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Are you experiencing pain? We treat a variety of common conditions that cause pain, as well as those that are more uncommon such as Trigeminal Neuralgia. It is time to get the proper diagnosis to move forward with an appropriate treatment plan.
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The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.
