Trigeminal Neuralgia

Trigeminal neuralgia is a condition affecting the trigeminal nerve, or the nerve that carries sensation messages from the face to the brain. The condition is characterized by chronic pain that can be triggered even by the mildest strokes on the face. 

You may feel short and mild attacks at first, but the attacks usually progress to a longer bouts of excruciating pain overtime. Women aged 50 and up are more likely to experience this condition. Having this condition, however, does not mean you have to endure pain all your life. 

Treatment options are available and they are generally effective in managing the condition.

The symptoms of trigeminal neuralgia include:

• Jabbing pain 
• Attacks of pain that are triggered by activities involving the face, such as brushing the teeth, chewing, and even speaking
• Episodes of pain that last for several seconds to a few minutes
• Episodes of attacks that last for days and weeks, or sometimes for months
• Constant feeling of pain in the areas affected by the trigeminal nerve (cheek, gums, lips, jaw, teeth)

See a doctor at once if you feel sudden, unexplainable facial pain or recurring pain in particular. Also, if the pain seems to be resistant to over the counter painkillers, you have to see your doctor immediately. 

Trigeminal neuralgia is caused when the function of the trigeminal nerve is messed up. The problem, usually, lies on the contact between a blood vessel and the trigeminal nerve. This occurrence causes the trigeminal nerve to malfunction. 

The condition is often caused by aging, but sometimes, it is a complication of a disorder like multiple sclerosis. A less common cause is the growth of tumor that may compress the trigeminal nerve, while others have it due to a lesion or abnormalities in the brain. Stroke, surgical injuries, and facial trauma can also be a cause of trigeminal neuralgia.

Triggers

In trigeminal neuralgia, pain can be triggered by shaving, eating and drinking; brushing the teeth, putting makeup on, washing the face, smiling, touching the face, and even encountering a breeze.

If you have the symptoms of trigeminal neuralgia, visit your doctor as soon as possible to receive a diagnosis. Making an early diagnosis can greatly help your condition. Your doctor may advise you to go to a neurologist for a more thorough diagnosis.

You may prepare beforehand by writing down the following:

• Your symptoms and how long you’ve been experiencing them
• Triggers that usually bring the attacks
• Other medical conditions, if there are any
• Medications, vitamins and supplements you’ve been recently taking

You may also want to write down questions you want to ask your doctor. Basic questions that can be of use include:

• What is causing my pain?
• Are there any diagnostic tests needed to be done?
• What are the treatment options?
• What are the side effects of those treatment options?
• Are the symptoms guaranteed to improve after treatment?

Apart from these questions, do not hesitate to ask your doctor if there is something you didn’t understand. You will also have to answer some questions regarding your symptoms, past and present medical conditions, or if you have tried anything (OTC drugs, etc.) to ease the pain. 

The diagnosis depends mainly on the type of pain you are experiencing. Trigeminal neuralgia is characterized by sudden pain that is similar to electric shock. The location of the pain is also a factor, as well as the triggers. 

Diagnostic tests are also done to confirm if you have trigeminal neuralgia and also to determine its underlying causes. The tests may include:

1. Neurological examination. This is a physical examination that involves touching the parts of the face and checking where exactly the pain takes place. Moreover, this can help determine whether the symptoms are a result of a compressed nerve or something else. 
2. MRI. MRI or Magnetic Resonance Imaging can be done to rule out multiple sclerosis and tumors that may be causing the problem. In rare cases, the doctor may request a magnetic resonance angiogram, in which a special dye is injected into the blood vessel to highlight the flow of blood and view the veins and arteries. It is vital to have an accurate diagnosis because the facial pain you are experiencing may be due to various conditions. 

Treatment for trigeminal neuralgia typically begins with medications. Most people respond to medications positively, thus, would not require other forms of treatment. Your doctor may prescribe drugs that help block the signals of pain that travel to the brain. 

These drugs include:

• Anticonvulsants. One of the most prescribed medications to treat trigeminal neuralgia. Anticonvulsants like carbamazepine, oxcarbazepine, lamotrigine, and phenytoin are typically used. 
• Antispasmodic agents. These muscle-relaxing agents can help alleviate the symptoms and minimize the number of attacks. Baclofen is one example of antispasmodic drugs, which can be given as is, or combined with a certain anticonvulsant.

When medications do not work, your doctor may suggest other treatment options, such as:

• Botox injections. There are studies showing Botox injections can help ease the pain caused by trigeminal neuralgia. The treatment is still not a popular treatment method, however, since there is only little research backing the claim.
• Surgery. Surgery is done to stop the compression of the trigeminal nerve due to contact with a blood vessel. During surgery, the trigeminal nerve is damaged to avoid further malfunctioning. The process may cause temporary, or even permanent numbness of the face; and like any other surgical process, the symptoms are not guaranteed to completely subside and could recur after a few months or years. 
• Microvascular decompression and Gamma Knife radiosurgery are two common types of surgery done to treat trigeminal neuralgia.

Other procedures

Apart from medications and surgeries, your doctor may want to try other types of procedures to treat trigeminal neuralgia. These include Rhizotomy, in which the nerve fibers are destroyed to generally numb the face. 

Glycerol injection, balloon compression, and Radiofrequency thermal lesioning are different types of Rhizotomy often used to treat this condition. 

When choosing your options, it is very important to discuss each of one with your doctor. Ask the pros and cons and possible risks and complications that go with your treatment choice. 

Remedies or alternative treatments are not proven to treat trigeminal neuralgia, but some people claim to have improved using this course of medicine. If you choose to use alternative options, make sure to discuss it first with your doctor to avoid any adverse effects. 

Popular alternative treatments for trigeminal neuralgia are acupuncture, chiropractic therapy, nutritional and vitamin therapies, and biofeedback therapy. 

Lifestyle modifications are necessary in order to cope with trigeminal neuralgia.

Living with this condition can prove to be difficult. Trigeminal neuralgia may greatly affect your productivity and quality of life, as well as impact your relationships with family and friends.

Finding an encouraging and understating support group can be a big help. 

Groups in which the members share own experiences and know about the latest treatment options can give you the support and encouragement you need.

It is also important to inform your trusted friends and family members about your condition to avoid any misunderstanding. 

Ask your doctor about a support group near you that can cater to your needs.