Trigeminal neuralgia is a painful disorder of the fifth cranial nerve also called the trigeminal nerve. The word, trigeminal has been derived from the Latin word ‘tria’ which means three, and ‘geminus’ which means twin. Each cranial nerves divides the head into the ophthalmic, maxillary, and mandibular nerves. This nerve travels into the skull controlling sensations of the face and the intense, stabbing, electric shock-like pain is due to irritation in this nerve. This excruciating painful ailment also known as ‘tic douloureux’ affects the mouth, cheek, nose, and other areas of the face. At the onset of the condition, the bouts of pain may be short, but if it is not treated on time, trigeminal neuralgia begins to worsen. Sometimes, the pain can be incapacitating, affecting the person’s quality of life in many ways.
While the exact cause of trigeminal neuralgia is still unknown, it is reported that about 150,000 people are diagnosed with this illness every year. It is most common in people over the age of fifty and primarily affects females more often than males.
Trigeminal neuralgia is of two types: Primary and Secondary.
Primary TN: This type occurs when there is compression of the nerve at the base of the head. This compression usually occurs due to contact between an artery or vein and the trigeminal nerve at the base of the brain. Undue pressure on the nerve causes the nerve to malfunction and bring immense pain.
Secondary TN: The second type is caused by pressure on the nerve from a tumor, cyst, injury to the face, or some form of medical condition that can damage the myelin sheath. Myelin sheath are protective layers that protect nerve cells allowing electrical impulses to transmit signals. When these myelin sheaths are damaged, the impulses backfire.
Trigeminal neuralgia may be triggered by the following:
- Touching the skin or washing the face
- Shaving, brushing or blowing the nose
- Drinking beverages or swallowing
- Applying makeup or shaving
- Smiling or during any conversation
- Sinus or ear infection
- Movements such as walking or travelling in a car
- Cluster headaches or migraines
- Medical conditions such as lupus can affect trigeminal nerve
Trigeminal neuralgia patients report that their pain is spontaneous and arrives out of nowhere. The most common symptoms of TN pain are:
- Distressing pain in the upper or lower jaw
- Sharp or sporadic pain around the eyes, lips, forehead and scalp
- A sudden sensation of electrical shocks that transform into excruciating pain in a short span of time
- In case of secondary trigeminal neuralgia, a constant, burning, aching pain is noticeable but stabbing sensation not as intense as primary TN
- Disappearing and reappearing pain for weeks, months or even years
- Uncontrollable facial twitching
Since there are no specific diagnostic tests and the symptoms of this ailment are very similar to other facial pains, it is extremely difficult to diagnose trigeminal neuralgia. TN symptoms are often confused with the pain caused by a dental abscess or cavity. It is very important to keep a check on unusual, sharp pain around the eyes, nose, jaw, forehead. In case the pain is recurring, seeking medical care at the earliest is a must.
Treatment options usually include:
Trigeminal neuralgia cannot be cured in most of cases but there are effective ways to alleviate the pain. In the early stages, anticonvulsive medications are given at low doses, and depending on how well the patient is responding, they are increased.