Trigeminal neuralgia – Types, Causes, and Symptoms

Trigeminal neuralgia is a disorder that makes one side of the face experience pain that feels like an electric shock. The trigeminal nerve, which transmits feeling from your face to your brain, is impacted by chronic pain syndrome.

Trigeminal neuralgia patients may experience unbearable pain when even minor facial stimulation, such as brushing teeth or applying makeup.

The term “tic douloureux” also refers to trigeminal neuralgia. The discomfort is usually concentrated on the lower face and jaw. However, it can also occasionally affect other portions of the face, such as the area above the eyes and the area surrounding the nose.

Type 1, or TN1, is the most prevalent kind of trigeminal neuralgia and is characterised by abrupt, intense face pain attacks.

The Trigeminal nerve

Trigeminal nerve is one of the 12 pairs of nerves connected to the brain.It is in charge of carrying touch and pain signals from your head and face to your brain. The following are some of its branches.

The ophthalmic branch

Ophthalmic branch consists of forehead and the upper part of your face.

The maxillary branch

Maxillary branch consists of Cheeks, nostrils and top lip.

The mandibular branch

It consists of chewing muscles in jaw, lower lip and lower gum.

Types of Trigeminal neuralgia

Trigeminal neuralgia comes in two primary types.

Typical (Type 1) trigeminal neuralgia

Sharp, acute, intermittent pain episodes are probably what you will encounter. You can experience pain or a burning feeling all over your face from a few seconds to two minutes.

Atypical (Type 2) trigeminal neuralgia

The patient will experience less severe but more widespread pain. You’ll probably have ongoing discomfort, mainly stabbing and burning sensations, coupled with lingering aches and pains.

Causes of Trigeminal neuralgia

Trigeminal neuralgia can result from several disorders, but it usually happens when a blood vessel puts pressure on a nerve close to the brain stem.

Although it’s not as prevalent, this illness can also be brought on by a lesion or tumour that compresses your nerves. You could experience face nerve pain that is comparable to the signs of trigeminal neuralgia if your trigeminal nerve is damaged due to oral or sinus surgery, a stroke or facial trauma.

Symptoms of Trigeminal neuralgia

The majority of patients claim that their pain starts suddenly without any intimation or warning. Other individuals report experiencing pain after a car accident, a facial or dental pain.

The following are said to be some of the symptoms of Trigeminal neuralgia:

• Feeling of numbness or tingling.
• Short sharp pain bursts.
• Regular pain and aches

Additional signs include:

• Discomfort that comes in brief bursts and feels electric or stabbing
• Sudden bouts triggered by tasks like chewing or chatting
• Burning on entire one side of the face

Risk factors for Trigeminal neuralgia

The following are typical risk factors for this condition:

Age

As people get older, their chance of acquiring trigeminal neuralgia rises. This is mainly caused by nerve problems, which can form new contacts between nerves and blood vessels.

Multiple sclerosis

Multiple sclerosis is a persistent condition that can harm the brain, spinal cord, and optic nerves. Trigeminal neuralgia may result from it since it also affects the nerves’ myelin sheath, which serves as protection.

Diagnosing Trigeminal neuralgia

Trigeminal neuralgia will be diagnosed by your doctor primarily based on how you describe the pain, which may include:

Type

Trigeminal neuralgia-related pain is sudden, shock-like and transient. The intensity of the pain varies on the type of trigeminal neuralgia.

Location

Your doctor will be able to determine whether the trigeminal nerve is implicated by looking at the areas of your face that are painful.

Triggers

Normal triggers for pain associated with trigeminal neuralgia include eating, speaking, lightly touching your face and even feeling a chilly wind.

To diagnose trigeminal neuralgia and identify the underlying reasons for your disease, your doctor may perform a variety of tests, including.

Neurological assessment

Your doctor can pinpoint the exact location of the pain and detect which branches of the trigeminal nerve may be impacted by touching and inspecting various parts of your face to diagnose trigeminal neuralgia.

Magnetic resonance imaging (MRI)

To identify whether multiple sclerosis or a tumour is causing trigeminal neuralgia, your doctor might request an MRI of your head. When viewing the arteries and veins and highlighting blood flow, your doctor may determine the presence of trigeminal neuralgia.

Trigeminal neuralgia treatment

Treatment options for trigeminal neuralgia symptoms include medication, surgery, and complementary therapy.

Medications

Anticonvulsant drugs

Usually, the first drug of choice for treating trigeminal neuralgia pain is carbamazepine. Other anticonvulsant medications that your doctor might recommend include oxcarbazepine, phenytoin, lamotrigine, sodium valproate, gabapentin and topiramate.

Anti-spasmolytic medications

Baclofen, a muscle relaxant, may be administered either alone or in combination with carbamazepine. Drowsiness, nausea and disorientation are possible side effects.

Botox injections

OnabotulinumtoxinA (Botox) injections may lessen trigeminal neuralgia pain in those who are no longer assisted by medication.

Surgery

You might be a candidate for surgery if none of these treatments works and is getting worse over time. There are numerous surgical procedures available to you.

Based on the degree of your discomfort, physical health, relative risks and advantages of the procedure, and other factors, your doctor will probably suggest any of the surgery if needed.

Balloon compression

The surgeon will insert a tube through your cheek and up to the trigeminal nerve. They then pass a catheter equipped with a little balloon through the tube. The nerve is compressed while the balloon is inflated, harming the pain-producing fibres. After the procedure, the provider removes the balloon and catheter. This surgery has been shown to improve symptoms for one to two years.

Radiofrequency thermal lesioning

Radiofrequency thermal lesioning is performed in cases where trigeminal neuralgia becomes difficult to treat. However, to pinpoint the precise location of the discomfort on the trigeminal nerve, the surgeon will enter a needle through your cheek and all the way to the base of your skull. As a result of this Radiofrequency thermal lesioning, you can potentially get rid of face numbness.

Open Surgery

The trigeminal nerve root is exposed microsurgically as part of microvascular decompression, and a blood artery that may be compressing the nerve is identified and gently moved away from the compression site. Decompression could lessen sensitivity and help the trigeminal nerve heal and return to its more typical, pain-free state.

Conclusion

Although trigeminal neuralgia is not a life-threatening condition, it can significantly impact the quality of life. You could develop a fear of carrying out several everyday tasks since they can cause brief, severe painful episodes.

Even though this is a condition that is likely to persist, in some capacity, for the rest of your life, a variety of surgical procedures and therapy alternatives can help you live every day, essentially pain-free life.

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