About the disease
The first thing you need to know about trigeminal neuralgia is that it is a chronic pain disorder of the trigeminal nerve, which is responsible for facial movements involved in mastication and also for carrying sensations from the face to the brain. The trigeminal nerve, also known as the fifth cranial nerve, is responsible for chewing, biting and general processing of food. Trigeminal neuralgia does not control movements of the lips or facial expressions.
A person develops this disease if there is a paucity of myelin, which is a substance surrounding the nerves. Trigeminal neuralgia is considered to be a rare disease with 1 patient having it out of 30,000 people. It usually develops in persons of 50-55 years and over. Only in rare cases will pain be felt on both sides of the face; usually it affects only one side. Pain is concentrated in one part of the face. It can exacerbate and subside in forms of seizures, with fluctuating frequency. During the attacks, the sufferer cannot eat, brush their teeth, talk or even wash their face. Even the slightest touch brings new unpleasant sensations. As patients do not know when the next attack is going to happen, their anxiety grows and they live in a state of constant expectation of another attack.
In most cases it is difficult to identify exact cause of this disease. According to medical website News Medical, trigeminal neuralgia can be caused by abnormal nerve pressure or multiple sclerosis. It can also appear after herpes as a post-traumatic effect of the infection. Sometimes people suffer nerve damage due to an accident.
Overall, trigeminal neuralgia is characterized by severe pain in the trigeminal nerve, which appears suddenly in the form of attacks. Such seizures may happen more and more often if the person does not undergo treatment. Pain may range from a mild dull ache to an unbearably explosive attack, which can even cause the sufferer to lose consciousness. There may be 3 to 10 attacks per day, which could last from several minutes to several hours. Patients describe these attacks as unbearable, likening the sensation to that of an electric shock. Attacks can start suddenly while talking or eating. Sometimes even wind can provoke a seizure. Attacks occur cyclically; they come and go, so the remission period may last several months or even years. Pain may consequently result in numbness when the sufferer cannot move the muscles in their face. The most common symptoms are:
- Strong pain in the facial nerve
- Pressing sensation
- Burning sensation
- Compression of the nerves
- Crumbling of the teeth
- Constant depression
- Lack of vitality
There is another type of trigeminal neuralgia which is called atypical TN. It has slightly different trigeminal neuralgia symptoms, as the pain is felt like a burning sensation, not like an electrical shock. It can usually be alleviated by an anticonvulsant or very powerful painkillers.
Very often trigeminal neuralgia becomes misdiagnosed, as most often the doctors think that patient experiences minor nerve problem. Almost in 60% of cases trigeminal neuralgia is thought to be something else. The exact diagnosis may be determined only after person’s pain does not subside even after several courses of nerve treatment.
Although trigeminal neuralgia cannot be fully cured, there are several treatment options that can improve the patient’s condition. Some patients are prescribed with antiepileptic drugs; some receive antidepressants or strong anti-anxiety pills. They do not prove to be very effective.
The main drug used in medical trigeminal neuralgia treatment is Tegretol. It has been used for the treatment of trigeminal neuralgia since 1962. Once this medication has reduced the patient’s pain, its use is continued in order to prevent any future attacks. Some doctors also use nicotinic acid to help the patient feel better.
Physiotherapy for the treatment of trigeminal neuralgia is quite diverse. The patient may be prescribed with biodynamic currents, electrophoresis, acupuncture and laser therapy. All of these therapy options aim to improve the state of the affected nerve cells by either warming them or conducting little doses of electricity to them. Physical therapy techniques are used only in combination with medication in order to achieve better and faster effects.
- Regarding trigeminal neuralgia, the most common type of surgery is microvascular decompression. The aim of this surgery is to separate vessel and nerve using microsurgical devices.
- Other trigeminal neuralgia surgery is rhizotomy, when the doctor destructs the nerve root using an electric current or a needle electrode.
- Balloon compression is also an effective trigeminal neuralgia surgery. The doctor achieves cessation of pain impulses by compressing them by means of a spray, which is applied to the nerve via a catheter.
- Lonizing radiation is a non-invasive technique, which applies radiation
- Radiofrequency ablation also uses radiation to destroy the nerve with heat
Pain attacks do not disappear immediately after surgery. But it subsides after several days. Simple medications are not likely to help. Therefore, all patients with trigeminal neuralgia are advised to get a timely and proper surgical treatment.