Trigeminal neuralgia is chronic painful condition involving the trigeminal nerve, which has nerve branches into three parts of the face (Tri means three) the forehead, cheeks and lower jaw.

There 3 branches of the trigeminal nerve are responsible for providing sensation to the face:

  • The first branch that controls sensations in eye, upper eyelid and forehead.

  • While the second branch controls sensation in the lower eyelid, cheek, nostril, upper lip and upper gum

  • And the third branch controls sensations in the jaw, lower lip, lower gum and some of the muscles that are used for chewing.

Hence, the area of pain is usually limited to one side of the face and typically involves the lower face and jaw, although sometimes it affects the area around the nose and above the eye.

CAUSES OF TRIGEMINAL NEURALGIA: 

In most of the cases trigeminal neuralgia are caused by compression of the trigeminal nerve root, usually by an abnormal loop of an artery or vein in the face. Less commonly, compression of the trigeminal nerve may occur from a cyst or tumor, like an acoustic neuroma.

Inflammation of the nerve, like that which occurs in multiple sclerosis, can also cause trigeminal neuralgia.

SYMPTOMS:

1.Tingling or numbness in the face before pain develops
2.The pain can range anywhere from an intense, stabbing, electric shock-like pain to a more constant, aching, burning sensation.

3.Pain in one side of the face, or, less frequently, both sides

4.Sudden attacks of pain triggered by stimuli that are usually not painful, such as by touching the face, chewing, speaking, or brushing the teeth

 

TRIGGERS OF TRIGEMINAL NEURALGIA:
It’s common for certain activities to trigger the attacks of pain.

Chewing
Brushing your teeth
Smiling
Talking or laughing
Shaving
Exposure of your face to cold air
Light touching of the face

DIAGNOSIS:

If the symptoms indicate trigeminal neuralgia, your doctor may examine face to determine the affected areas.

Often brain MRI is needed to rule out secondary causes like a tumor or multiple sclerosis first.

TREATMENT:


There are several treatment options.

Generally medications are prescribed that can relieve trigeminal neuralgia pain such as anti-depressants, anti-seizure drugs and short-term narcotic pain medications.

When the person ceases to respond to medications or suffers from side effects, more invasive treatment options such as surgery is needed.

 

SURGERY:

Surgery for trigeminal neuralgia aims to: Stop artery or vein from pressing against the trigeminal nerve and damage the trigeminal nerve so that the uncontrolled pain signals stop. Damaging the trigeminal nerve may lead to temporary or permanent facial numbness. Surgery can provide relief, however symptoms may return months or years later.



PREVENTION:

  • Eating soft diet

  • Avoiding foods that are too cold or hot

  • Washing your face with lukewarm water

  • Using cotton pads when washing your face

  • If brushing tooth triggers an attack, rinsing your mouth with lukewarm water after eating.

-Dr Krishna Priya

References:

https://www.mayoclinic.org/diseases-conditions/trigeminal-neuralgia/symptoms-causes/syc-20353344

https://www.webmd.com/pain-management/guide/trigeminal-neuralgia#1

 

 

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