Trigeminal Neuralgia
Trigeminal neuralgia is a sudden, sharp pain in the face that lasts for a few seconds or minutes each time. In most cases, trigeminal neuralgia is caused by pressure on the nerve and appears on one side of the face, although in rare cases it can appear on both sides of the face.
Symptoms
The main symptom of trigeminal neuralgia is a sharp or stabbing pain in the face that occurs suddenly and involves the lower jaw, upper jaw, cheek, less frequently the eye socket and forehead area.
At such times, you may feel:
- A tingling sensation and numbness
- The feeling of pain or a burning sensation
- Over time, you may experience regular spasmodic pain that lasts for days or months. It is also possible that the pain will disappear completely and not recur for many years.
Causes
In most cases, the pain is caused by pressure on the largest nerve inside the skull.
An attack of neuralgia can be triggered by actions and movements such as:
- talking
- smiling
- chewing
- brushing teeth
- light touch
- shaving
- swallowing
- cool breeze
- head movements and more
The causes of trigeminal neuralgia can be many, including:
- Compression of the blood vessels (80-90%) inside the skull
- Pressure from a mass inside the skull
- Multiple sclerosis is a long-term illness affecting the central nervous system (brain and spinal cord).
There are also external factors (e.g. windy weather, cold or hot drinks and food) that should be avoided so as not to provoke pain.
Who can get it?
It is rare for trigeminal neuralgia to develop before the age of 40; it develops with age and is more common in women.
Diagnosis
The pain is mostly felt in the area of the lower jaw, teeth and gums, so people with this problem often go to the dentist. If the dentist cannot determine the cause of the pain, be sure to see a general practitioner. Before a diagnosis can be made, other causes of facial pain must be ruled out to determine which form is causing the condition, classic or otherwise (symptomatic trigeminal neuralgia).
Other diseases that should be ruled out:
- dental infection or decayed tooth
- migraine
- pain in the joint of the lower jaw
- temporal arteritis, a disease that causes inflammation of the blood vessels, which can lead to blindness or stroke
- traumatic damage to the facial nerve (post-traumatic neuralgia)
- prolonged facial pain of unknown cause (idiopathic).
Magnetic resonance imaging is used for diagnosis and is crucial in excluding or confirming intracranial compression.
Treatment
Initially, medication is prescribed to relieve facial pain. The medication slows down nerve electrical impulses and prevents the transmission of pain. Conventional painkillers are ineffective in treating pain. Often, however, the medication only relieves the patient from pain for a short time and then side effects occur, in which case surgery is necessary. Studies show that surgery is effective in relieving pain and preventing its recurrence. The following surgical procedure is generally carried out: Microvascular decompression - during this procedure, the surgeon separates and releases the blood vessels from the trigeminal nerve.
