Trigeminal Neuralgia Treatment
Introduction
Trigeminal neuralgia is a chronic painful condition of the facial region. It is due to trigeminal nerve compression. Patient with this condition experience throbbing and stabbing pain. Doctors diagnose the condition through neurological examination and imaging techniques. Doctors may recommend medications and surgery for managing the disease.
What Is Trigeminal Neuralgia?
The trigeminal nerve is the pair of nerves responsible for sensory response in the facial region. Once the trigeminal nerves leave the brain, they subdivide into three different branches. These are the ophthalmic nerve, maxillary nerve, and mandibular nerve. Patients with trigeminal neuralgia experience excruciating pain in the face. Even the slightest of pain triggers severe pain in trigeminal neuralgia. The condition is more common in the elderly. Women are at increased risk for this condition than men.
What Are The Types Of Trigeminal Neuralgia?
Following are the different types of trigeminal neuralgia:
- Typical trigeminal neuralgia: It is also known as type 1 trigeminal neuralgia. The patient with this type experiences sudden episodes of pain and burning sensation in the facial region. The symptoms exist for few minutes to few hours. The episodes are frequent, and there are pain-free periods between them.
- Atypical trigeminal neuralgia: In atypical trigeminal neuralgia, the patients experience continuous burning or stabbing sensation. The severity of pain is less than the typical trigeminal neuralgia. Doctors generally have difficulty in managing the symptoms of atypical neuralgia.
The patients with trigeminal neuralgia have the following symptoms:
- Severe stabbing pain equivalent to electric shock.
- Episodes are progressive and reduce the quality of life.
- Episodes emerge even with slight stimulation like touching the face or brushing teeth.
- Pain generally on one side of the face.
- Pain lasting for few minutes to few hours.
- Facial pain may be of a broader spectrum or concentrating at one point.
- Severe stabbing pain equivalent to electric shock.
- Episodes are progressive and reduce the quality of life.
- Episodes emerge even with slight stimulation like touching the face or brushing teeth.
- Pain generally on one side of the face.
- Pain lasting for few minutes to few hours.
- Facial pain may be of a broader spectrum or concentrating at one point.
What Are The Causes Of Trigeminal Neuralgia?
The primary cause of trigeminal neuralgia is the nerve compression at the base of the head at the point of interaction between the brain and spinal cord. Primary trigeminal neuralgia occurs due to nerve compression by healthy arteries and veins. The other causes of this condition, as seen in secondary trigeminal neuralgia, are cyst, multiple sclerosis, damage to the myelin sheath, damage to the nerve due to infection or surgical procedure, and facial injury. In some cases, the doctors are unable to determine the exact cause of this condition.
Triggers
There are various triggers for initiating the pain of trigeminal neuralgia. These are:
- Talking
- Drinking
- Brushing
- Eating
- Smiling
- Face washing
- Exposing face to air or wind
What Are The Risk Factors Of Trigeminal Neuralgia?
Various factors increase the risk of trigeminal neuralgia. These are:
Age: The risk of developing this condition increases with age. The Elderly are more prone to developing trigeminal neuralgia. It may be due to alteration in the anatomy of blood vessels resulting in nerve compression.
Gender: Women are at increased risk for developing this condition.
Underlying medical condition: People with hypertension and stroke are at more risk for trigeminal neuralgia.
When To See Doctor
Do not ignore your symptoms. It may result in disease progression that may require a more aggressive approach for managing pain. Consult your doctor if you have:
- Pain on one side of the face.
- Frequent episodes of pain
- Pain initiates with a slight sensation.
- Severe, throbbing or stabbing facial pain
- Reduced quality of life due to pain
- Any other symptoms that concern you
What Are The Diagnosis Of Trigeminal Neuralgia?
There are various ways to diagnose trigeminal neuralgia. Some of them are:
Physical examination: The doctor may have a preliminary diagnosis of the condition through the type of pain, location, and triggers that initiate the pain.
Neurological examination:The doctor may also conduct a neurological evaluation to determine the severity and type of branch affected by trigeminal neuralgia. A reflex test also helps in determining the cause.
Imaging techniques: The doctor may recommend various diagnostic methods for the diagnosis of trigeminal neuralgia. These are MRI, CT Scan and MRI angiogram.
What Are The Treatment Of Trigeminal Neuralgia?
There are various treatment options for managing trigeminal neuralgia. These are:
Medications : Your doctor may prescribe several medications to manage the symptoms of trigeminal neuralgia. These are anticonvulsants, antispasmodics, and Botox injection.
Surgery :Surgical methods also helps in relieving the symptoms of trigeminal neuralgia. Microvascular decompression helps in removing the blood vessels that compresses the nerve. There is a risk for pain recurrence after microvascular decompression. Other risks include numbness, reduced hearing, and stroke. The doctor may also recommend gamma knife surgery for damaging the trigeminal nerve.
Rhizotomy: During this treatment, the doctor destroys the nerve fibres through various techniques. These are using glycerol injection, Radiofrequency thermal lesioning, and balloon compression.
What Are The Complications Of Trigeminal Neuralgia?
Some of the trigeminal neuralgia complications are:
- Progressive and debilitating symptoms
- Reduced quality of life
- Facial numbness.
What Are The Prevention Of Trigeminal Neuralgia?
There is no way that you can prevent the occurrence of trigeminal neuralgia. However, you can reduce the risk of episodes through the following steps:
- Do not wash your face with cold water. Take lukewarm water.
- Do not eat too hot or too cold food.
- While brushing, use a soft brush with gentle pressure.
- Avoid any known triggers.