What is Trigeminal Neuralgia?
Trigeminal neuralgia, also known as tic douloureux, is a chronic condition that affects the 5th cranial nerve. In its typical form, TN causes extreme, sporadic burning or shock-like pain in the face. This pain comes on quickly and can last as long as two minutes. TN attacks can occur in rapid succession for up to two hours. There is also another form of TN known as atypical TN or TN2. This form involves a constant aching, burning, or stabbing pain that is lower in intensity than regular TN. Both types of TN can occur in the same person at once, and the pain can reach levels of intensity that are physically and mentally incapacitating.
A TN attack can be triggered by something as minute as shaving, washing the face, putting on makeup, or anything else involving contact with or moving of the face. TN rarely flares up when a person is sleeping, and the condition tends to get worse over time. While not a fatal disorder, medication can become less effective as it progresses, and affected individuals may develop a fear of daily activities because they’re worried about another attack.
TN occurs most often in people over the age of 50, although it can affect people of any age, including infants. It is more common in women than men, and the number of new cases per year is 12 out of 100,000 people. Don’t wait to get checked for TN ask your Dentist today.
TN can result from a variety of causes. For example, a blood vessel might be pressing on the trigeminal nerve. In this situation, the constant compression causes the myelin sheath (a protective coating that surrounds the nerve) to wear down over time. TN can also be caused by multiple sclerosis, which is a disease that causes the trigeminal nerve’s myelin sheath to deteriorate. In rare cases, a tumor may be the cause of TN. The trigeminal nerve can also be injured by things like surgery, a stroke, or facial trauma.
Diagnosis and Treatment Options
TN is diagnosed based on the patient’s description of their symptoms, along with physical and neurological examinations. Because there are other disorders that can cause facial pain, these should be ruled out first before a TN diagnosis is given.
Fortunately, there are a wide variety of treatment options available for those suffering from TN. These include medication, surgery, and complementary approaches. Anticonvulsant medicines are generally effective in treating typical TN. Trycyclic antidepressants are sometimes used as well. Opioids are effective in some cases with treating TN2. Surgery for TN can produce some facial numbness afterward, and there is a possibility of TN returning later on.
Another procedure sometimes used to treat TN is known as a rhizotomy. In this procedure, the patient’s nerve fibers are intentionally damaged in order to remove their sense of pain. The downside to this is that it is sure to cause a degree of sensory loss and facial numbness.
Complementary approaches to TN are often used in combination with medication. These techniques focus on the patient’s well-being, and can include things like low-impact exercise, yoga, visualization exercises, aroma therapy, meditation, acupuncture, chiropractic work, biofeedback, and vitamin/nutritional therapy. Botulinum toxin injections may also help with pain relief, as they block the activity of sensory nerves. Psychological therapy is also recommended to help the patient cope with the emotional effects of the disorder.
Current TN Research
Research into TN is currently being conducted by the National Institute of Neurological Disorders and Stroke (NINDS). This organization is the federal government’s leader in biomedical research on brain and nervous system disorders. A current study uses a nasal spray to deliver medicine into the nasal cavity’s tissue. This reduces the pain associated with TN. There is also current interest and research into the role estrogens might play in nerve pain. A possible treatment option would be compounds that reduce the effect that estrogen has on nerves sending pain signals to the brain. There are a number of other foundations researching TN besides NINDS, and studies are being conducted currently.