Trigeminal Neuralgia

Trigeminal Neuralgia is a pain that is described as among the most acute known to mankind. It is also known as tic douloureux. It is a chronic pain condition that causes extreme, sporadic, sudden burning or shock-like face pain that lasts anywhere from a few seconds to as long as 2 minutes per episode. The condition is characterized by pain often accompanied by a brief facial spasm or tic. Pain distribution is unilateral and follows the sensory distribution of cranial nerve V, typically radiating to the maxillary (V2) or mandibular (V3) area. If you have trigeminal neuralgia, attacks of such pain are frequent and can often seem unbearable. These painful attacks can be spontaneous, but they may also be provoked by even mild stimulation of your face, including brushing your teeth, shaving or putting on makeup. Trigeminal neuralgia is considered by many to be among the most painful of conditions and has been labeled the suicide disease, due to the significant numbers of people taking their own lives because they were unable to have their pain controlled with medications or surgery.

Trigeminal neuralgia affects the trigeminal nerve, one of the largest nerves in the head. There is some evidence that the disorder runs in families, perhaps because of an inherited pattern of blood vessel formation. It usually occurs after the age of 70 and is unusual in anyone under the age of 50. Although sometimes debilitating, the disorder is not life-threatening. It is a disorder of the trigeminal nerve, which is the fifth and largest cranial nerve. The pain of trigeminal neuralgia may occur in a fairly small area of your face, or it may spread rapidly over a wider area. A less common form of the disorder called "Atypical Trigeminal Neuralgia" may cause less intense, constant, dull burning or aching pain, sometimes with occasional electric shock-like stabs. It affects women three times more frequently than men. This condition may also occur in younger people with multiple sclerosis. Two to four percent of patients with TN, usually younger, have evidence of multiple sclerosis, which may damage either the trigeminal nerve or other related parts of the brain.

Causes of Trigeminal neuralgia

The common causes of Trigeminal neuralgia include the following:

• The cause of the pain usually is due to contact between a normal artery or vein and the trigeminal nerve at the base of your brain.
• Drinking.
• The cause of the pain usually is due to contact between a normal artery or vein and the trigeminal nerve at the base of your brain.
• Physical nerve damage or stress may be the initial trigger for trigeminal neuralgia.
• Sometimes, the cause of trigeminal neuralgia is a blood vessel or small tumor pressing on the nerve.
• Disorders such as multiple sclerosis (an inflammatory disease affecting the brain and spinal cord), certain forms of arthritis, and diabetes (high blood sugar) may also cause trigeminal neuralgia, but a cause is not always identified.

Symptoms of Trigeminal neuralgia

Some symptoms related to Trigeminal neuralgia are as follows:

• Pain is brief and paroxysmal.
• Increased sensitivity of the skin or numbness of the affected skin area (feeling similar to a local anesthetic, such as a Novocaine shot).
• Difficulty sleeping.
• An attack of trigeminal neuralgia can last from a few seconds to about a minute.
• Loss of appetite.
• Stabbing facial pain.
• Jaw pain.
• Impaired function of affected body part due to pain, or muscle weakness due to motor nerve damage.

Treatment of Trigeminal neuralgia

Here is list of the methods for treating Trigeminal neuralgia:

• Medicines such as anticonvulsants and tricyclic antidepressants.
• Mild over-the-counter analgesics such as aspirin, acetaminophen, or ibuprofen may be helpful for mild pain. Narcotic analgesics such as codeine may be needed for a short time to control severe pain.
• Doctors may sometimes prescribe other medications, such as lamotrignine (Lamictal) or gabapentin (Neurontin).
• Pain may be treated long-term with an opioid such as methadone in some patients, but due to the nature of the neuralgia, traditional analgesics typically have negligible effect.
• Pain specialists use invasive therapy, including nerve blocks as well as nerve destruction, and nerve decompression techniques, to treat trigeminal neuralgia
• If medication fails to relieve pain or produces intolerable side effects such as excess fatigue, surgical treatment may be recommended.

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