Trigeminal neuralgia is a chronic pain disorder involving episodes of severe facial pain. The pain is usually felt on one side of the lower face and around the mouth, but it can spread to other areas like the forehead and the back of the head. During an attack, even light touch or speaking can trigger excruciating pain. The condition can last for days or weeks, and the attacks may become more frequent over time. Medications and surgery may sometimes be necessary to control the episodes.
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What are the types of neuralgia?
- Trigeminal Neuralgia: This type of neuralgia is caused by nerve damage to the trigeminal nerve, one of the largest nerves of the face and head. It is characterized by intense pain and spasms in the cheek, forehead, jaw, or other areas of the face.
- Occipital Neuralgia: irritation or injury to the occipital nerve causes pain, numbness, and tingling sensations in the back of the head and neck.
- Glossopharyngeal Neuralgia: This rare type of neuralgia is characterized by sudden and severe pain in the back of the throat, tongue, and ear.
- Postherpetic Neuralgia: This type of neuralgia occurs after a shingles infection. It is usually described as a burning, stabbing, or shooting pain in the affected area that lasts several weeks or months.
- Posttraumatic Neuralgia: This type of neuralgia is caused by direct trauma to the nerve, such as a fracture, sprain, or crush injury. It may lead to ongoing pain in the affected area ranging from mild to severe.
What are the causes of trigeminal neuralgia?
The exact cause is unknown. However, studies have shown the following reasons are related to the disease:
- Compression of the trigeminal nerve: This is the most common cause. Compression of the trigeminal nerve can be caused by a blood vessel or an abnormality of the bone and tissue in the area of the nerve.
- Multiple sclerosis: is a disease in which the protective coating of the nerves is affected. It can cause inflammation of the nerve and result in trigeminal neuralgia.
- A tumour: A tumour can cause the trigeminal nerve to be compressed. It is less common but can be a cause.
- Certain infections, such as herpes zoster
- Injuries to the face
- Trauma to the nerve
What are the symptoms of the trigeminal nerve?
Common symptoms of trigeminal nerve dysfunction include:
- Facial pain, which can range from a dull ache to intense stabbing pain
- Headaches
- Sensitivity to touch on the face
- Muscle spasms in the face
- Numbness or tingling on the face
- Difficulty eating or talking
- Difficulty closing or opening the eye
- Vision problems
Who is more likely to get trigeminal neuralgia?
Trigeminal neuralgia is more common in people over age 50, but it can occur in people of all ages. Women are affected more often than men. People with multiple sclerosis, a tumour, or a history of facial trauma are at greater risk for developing trigeminal neuralgia.
How is trigeminal neuralgia diagnosed?
It is typically diagnosed through physical examination, detailed medical history, and neurological tests.
- An electromyogram (EMG) may measure facial muscle and nerve electrical activity.
- Magnetic resonance imaging (MRI) can provide detailed pictures of the trigeminal nerves and other surrounding structures.
- If the diagnosis is uncertain, a nerve block can be performed to numb the area and confirm the diagnosis of trigeminal neuralgia.
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How is trigeminal neuralgia treated?
The treatment focuses on reducing pain and improving quality of life. Medications may include anticonvulsants, muscle relaxants, antidepressants, and derivatives of vitamin B-12.
Further treatment options include physical therapy, nerve blocks, trigeminal nerve decompression surgery and gamma knife radiation therapy.
Surgical procedures may be used to decompress the trigeminal nerve or to destroy the trigeminal nerve. Other treatments that may be considered include nerve blocks and Botox injections.
To whom can I consult for trigeminal neuralgia?
If you are experiencing the symptoms, you should consult a neurologist. A neurologist is a medical doctor with specialized training and expertise in diagnosing and treating disorders of the brain, spinal cord, and nerves. The neurologist can take a detailed history and conduct a physical examination to diagnose it, order tests to rule out other possible causes and discuss treatment options.
Consult a Neurologist
- Dr. Vrajesh Udani- Neurologist in Mumbai
- Dr. Zehra Husain- Neuro Surgeon at Saifee Hospital, Mumbai
- Dr. YOGESH PATIDA- Neurologist at Bhaktivedanta Hospital, Mumbai
- DR. VISHAL KUNDNANI- Spine Surgeon in Mumbai
- Dr. Vinod Rambal- Neuro Surgeon in Mumbai
- Dr. Viswanathan Iyer- Neuro Surgeon at Hiranandani Hospital, Mumbai
- Dr. VISHWANATHAN IYER- Neuro Surgeon at Kohinoor Hospital, Mumbai
- Dr. Vivek Agrawal- Neuro and Spine Surgeon at Sir H. N. Reliance Foundation Hospital, Mumbai
- DR. VINAY S. CHAUHAN- Neurologist at Lilavati Hospital, Mumbai
References
- Trigeminal neuralgia – Illnesses & conditions | NHS inform. https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/trigeminal-neuralgia/
- Trigeminal Neuralgia – Janae Moss. https://janaemoss.com/2022/01/02/22925/
- Trigeminal Neuralgia: Symptoms, Causes, Treatment & Surgery. https://my.clevelandclinic.org/health/diseases/15671-trigeminal-neuralgia-tn