Trigeminal neuralgia (TN) is a chronic neuropathic pain disease affecting the trigeminal nerve in the face and has been known as the “suicide disease.” This nerve pacifies with the sensations that are felt on the face and then relays them to the brain. In several cases, talking, eating, or even touching the face is too painful due to the unbearable sensations experienced by the patient.
At NeuroSpine Thane, we have focused on creating awareness and helping people suffering from trigeminal neuralgia. In this blog let us explore some of the factors that lead to this disease, signs of the disease, and how it can be diagnosed.
What Causes Trigeminal Neuralgia?
Trigeminal neuralgia is a painful condition that results from the trigeminal nerve being affected through pressure or inflammation. Here are the primary causes:
- Blood Vessel Compression: More often than not, a blood vessel is compressed against the trigeminal nerve at the base, and this causes inflammation.
- Multiple Sclerosis (MS): TN may be caused by damage to the protective covering of the nerves (myelin sheath) in MS patients.
- Tumors or Lesions: Compression can be caused by growths near the trigeminal nerve.
- Facial Trauma or Surgery: Nerve damage may be caused by previous injuries or surgical procedures in the facial region.
- Idiopathic Causes: In some cases, the cause is not known exactly, but the symptoms don’t go away.
Symptoms of Trigeminal Neuralgia
Intense facial pain is the hallmark of trigeminal neuralgia. Here’s what you should look out for:
Sharp, Electric-Shock-Like Pain: Sudden, severe pain in the face that lasts 3–5 seconds to 3–5 minutes.
Unilateral Pain: It usually affects one side of the face, rarely both.
Triggered by Everyday Activities: Actions such as brushing teeth, chewing or touching the face can trigger pain.
Episodes of Pain: The symptoms may come and go in cycles, with periods of remission in between.
Burning or Aching Pain: In some patients there is a dull ache before or after the sharp attack.
How Is Trigeminal Neuralgia Diagnosed?
Trigeminal neuralgia is diagnosed at NeuroSpine Thane using a systematic and comprehensive approach, which provides precision and personalized care to each patient. Here is a detailed breakdown of the steps involved:
Detailed Medical History
The starting point of the diagnostic process is a review of the patient’s medical history. This is the step that is important for identifying what is specific to each person, such as patterns and triggers.
- Patients describe the nature of their pain—its duration, intensity, and frequency. For example, the sharp, electric shock-like pain that characterizes trigeminal neuralgia is a key indicator.
- The neurologist will inquire about common triggers like chewing, speaking, brushing teeth, or exposure to cold air.
- When and how the symptoms began, as well as how they’ve evolved over time, helps differentiate trigeminal neuralgia from other facial pain conditions.
- Any history of conditions like Multiple Sclerosis (MS), facial injuries, or surgeries is noted to identify potential underlying causes.
Physical and Neurological Examination
A hands-on evaluation helps confirm the diagnosis and rule out other conditions that may mimic trigeminal neuralgia.
- The neurologist lightly touches or applies pressure to different parts of the face to pinpoint areas of heightened sensitivity or pain.
- Reflexes associated with the trigeminal nerve are tested to detect any abnormalities that could indicate nerve dysfunction.
- Specific actions, such as asking the patient to chew or speak, may be performed to observe if they provoke pain episodes.
- The examination also checks for signs of other conditions like dental issues, sinus infections, or migraines that can cause similar symptoms.
Magnetic Resonance Imaging (MRI)
MRI is a cornerstone in diagnosing trigeminal neuralgia, as it provides detailed images of the brain and surrounding structures.
- High-resolution MRI scans can reveal whether a blood vessel is pressing against the trigeminal nerve—a common cause of TN.
- Any abnormal growths near the nerve pathway can be identified, helping to rule out more serious conditions like tumors.
- Changes in the trigeminal nerve itself, such as demyelination (loss of the protective sheath), may be visible in MRI scans.
- MRI can also detect plaques or other signs of MS, a condition closely associated with some cases of trigeminal neuralgia.
Advanced Imaging Techniques
When standard MRI does not provide enough clarity, advanced imaging methods are employed to ensure a definitive diagnosis.
- This specialized scan makes blood vessels more visible, allowing for detection of subtle compressions of the trigeminal nerve by arterial or venous arteries.
- 3D Constructive Interference in Steady State (CISS) imaging techniques provide high-resolution views of the trigeminal nerve and the surrounding area.
- Bone-related abnormalities that could affect the trigeminal nerve can be detected by computed tomography (CT), although less commonly.
Treatment for Trigeminal Neuralgia
Treatments of trigeminal neuralgia include medications, minimally invasive techniques, surgery, and changes in lifestyle.
Medications
- Anticonvulsants: The initial medical management (such as carbamazepine).
- Muscle Relaxants: Baclofen for pain relief.
- Antidepressants: Amitriptyline as a nerve signal-regulating drug.
- Pain Relievers: Medications that can be obtained OTC for minor pain.
Minimally Invasive Procedures
- Nerve Blocks: With a jab of the needle to give temporary relief.
- Radiofrequency Ablation: Using heat to interfere with pain messages sent by the nerve.
Surgical Options
- Microvascular Decompression (MVD): Reduces nerve pressure for long-term benefit.
- Gamma Knife Radiosurgery: A non-surgical and non-hazardous technique of utilizing radiation for managing chronic pain.
Lifestyle Changes
- Avoiding Triggers: Restrict activities such as chewing or other exposure to cold.
- Stress Management: Yoga or meditation can do it.
- Dietary Modifications: Mushy-type diets and not taking foods that are very hot or cold.
Conclusion
Trigeminal neuralgia is a terrible disease that severely disrupts the quality of life for those living with it. Early diagnosis and a proper treatment plan are what help keep the condition at bay. NeuroSpine Thane is dedicated to personalized care with state-of-the-art diagnostic techniques and compassionate care. If you or someone you know is suffering from trigeminal neuralgia, don’t hesitate to visit a doctor. This difficult condition is one that can be managed with awareness and timely intervention.
FAQs
What is the main cause of trigeminal neuralgia?
Compression of the trigeminal nerve, usually by a blood vessel at its base, causes irritation and pain, which is the main cause. Other causes are damage to the nerve from trauma, tumors near the nerve, or multiple sclerosis (MS). In some cases the cause is unknown (idiopathic).
How to relieve trigeminal nerve pain?
Medications such as anticonvulsants, nerve blocks, or minimally invasive surgical procedures such as microvascular decompression are relief options. Also, avoid triggers, lifestyle adjustments, and stress management. If persistent pain, seek specialist treatment.
Can trigeminal neuralgia repair itself?
Trigeminal neuralgia rarely runs its course. This condition can come and go, but without medical intervention, symptoms will not be effectively managed and will worsen over time.
