INFORMATION ON TRIGEMINAL NEURALGIA

Trigeminal neuralgia also known as Tic Douloureux, is a neuropathic disorder of the trigeminal nerve that causes episodes of intense pain in the eyes, lips, nose, scalp, forehead, and jaw. Trigeminal neuralgia is considered by many to be among the most painful of conditions and has been labeled the "suicide disease," due to the significant numbers of people taking their own lives because they were unable to have their pain controlled with medications or surgery. Trigeminal neuralgia pain is typically felt on one side of the jaw or cheek. Episodes can last for days, weeks, or months at a time and then disappear for months or years. In the days before an episode begins, some patients may experience a tingling or numbing sensation or a somewhat constant and aching pain. An estimated one in 15,000 people suffers from trigeminal neuralgia and It usually develops after the age of 40 and affects women in a 2:1 ratio.

SYNONYMS OF TRIGEMINAL NEURALGIA

1. Fothergill Disease
2. Tic Douloureux
3. Trifacial Neuralgia
4. Chronic meningeal inflammation
5. Multiple sclerosis, vascular anomalies

CAUSES OF TRIGEMINAL NEURALGIA

There are a number of causes of Trigeminal Neuralgia:-

1. Pressure of a blood vessel on the root of the trigeminal nerve.
2. Demyelinization of the nerve. In rare instances, Trigeminal Neuralgia is a symptom of Multiple Sclerosis which destroys the myelin sheaths protecting nerve fibers.
3. Trigeminal Neuralgia is rarely the first symptom of Multiple Sclerosis and typically appears in advanced stages of MS.
4. Pressure of a tumor on the trigeminal nerve
5. Physical damage to the nerve caused by dental or surgical procedures, injury to the face or infections.
6. Unknown. Not all cases seem to have a clear cause.

SYMPTOMS OF TRIGEMINAL NEURALGIA

1. Pain that occurs without warning or that is triggered by actions involving the face, such as chewing, speaking, face washing, brushing teeth, cold winds or touching a specific trigger spot, is the hallmark symptom of trigeminal neuralgia.
2. An attack of trigeminal neuralgia can last from a few seconds to about a minute.
3. Some people have mild, occasional twinges of pain, while other people have frequent, severe, electric-shocklike pain.
4. Pain is usually described as a sudden sharp electrical, shocking, stinging, stabbing pain

DIAGNOSIS OF TRIGEMINAL NEURALGIA

1. Magnetic resonance imaging or computerized tomography scans of the brain can eliminate some causes of trigeminal neuralgia, such as tumors, aneurysms or multiple sclerosis.

2. A trip to the dentist will reveal whether a problem with the teeth or gums is causing the pain.

3. For the test, alcohol is injected into the nerve to temporarily block its function. If the pain is relieved by the alcohol, cutting the nerve surgically or with a radiofrequency probe relieves the pain permanently.

TREATMENT OF TRIGEMINAL NEURALGIA

Treatment options include medicines such as anticonvulsants and tricyclic antidepressants, surgery, and complementary approaches.

Typical analgesics and opioids are not usually helpful in treating the sharp, recurring pain caused by Trigeminal Neuralgia.

If medication fails to relieve pain or produces intolerable side effects such as excess fatigue, surgical treatment may be recommended.

Several neurosurgical procedures are available. Some are done on an outpatient basis, while others are more complex and require hospitalization.