Trigeminal Neuralgia is a severe, shooting pain felt in one half of the face for a short duration of a few seconds to 2 minutes, caused by irritation of the trigeminal nerve. People who suffer from Trigeminal Neuralgia experience these attacks regularly for days, weeks, and in some cases months or years. While the number of attacks ranging from a few to a hundred times a day.
Location of pain
Pain in Trigeminal Neuralgia is commonly felt in the lower face, including your teeth, jaw, lips, or gums with less common involvement of forehead and eyes. Typically involving one half of the face but rarely can be felt on both sides of the face too.
Duration of pain
Pain is sudden in onset lasting for about 2 seconds up to a few minutes. The number of attacks can range from a few to 100 attacks per day. For some people, the pain and number of attacks may improve or disappear after their regular occurrence for days, weeks, or months. However, they reoccur after a few months and sometimes years.
Symptoms
- Constant itching, tingling and burning which latter evolves into episodes of shooting, excruciating pain.
- Pain with one specific focus.
- Attacks increase in their frequency with the passage of time.
Causes
Trigeminal Neuralgia is caused by irritation and compression of trigeminal nerve and disruption in its normal functioning. This can be due to a no of reasons, categorizing it into primary and secondary forms:
Primary Trigeminal Neuralgia:
Most commonly, a blood vessel comes in contact with Trigeminal nerve at the base of the brain, somewhere close to where it enters the brainstem, exerting pressure and thus causing hindrance in the normal functioning of the nerve.
Secondary Trigeminal Neuralgia:
The pressure exerted on the nerve can be due to a no of causes, including:
- A Cyst or a Tumor that lies heavily on the nerve.
- Malformation of blood vessels i.e. tangled arteritis and veins, compressing the nerve underneath.
- Multiple Sclerosis (MS) is an autoimmune disorder, in which the myelin sheath( a protective layer) around the nerve wears away, exposing the nerve to traumas and damage.
- An injury to the nerve during surgery or trauma can also be the cause.
Triggering factors
An episode of pain can be triggered by even a gentle touch while washing the face, applying makeup, shaving, or brushing teeth.
Daily activities like eating, drinking, and talking or even wind can sometimes trigger bouts of excruciating pain.
Treatment
Some of the Treatment Guidelines for Trigeminal Neuralgia are as follows:
Medications:
Anticonvulsants: Topiramate, Gabapentin, Phenytoin.
Tricyclic antidepressants: Amitriptyline, Nortriptyline.
Surgical:
Rhizotomy: A surgical procedure that involves damaging nerve fibers to block the pain. There are several forms of rhizotomy including microvascular decompression, radiofrequency thermal lesioning, glycerol injection, and some others.
Neurectomy: Involves cutting a part of the nerve.
Home remedies:
Yoga, exercise, aromatherapy, meditation, vitamin therapy, and acupuncture, may relieve the pain for some time.
FAQ
Yes, Multiple Sclerosis (MS) is an autoimmune disorder in which the myelin sheath wears away. This makes trigeminal nerve prone to damage.
Pain in Trigeminal Neuralgia is commonly felt in the lower face, including your teeth, jaw, lips, or gums with less common involvement of forehead and eyes.
Most commonly, a blood vessel comes in contact with Trigeminal nerve at the base of the brain, exerting pressure and thus causing hindrance in the normal functioning of the nerve.
