Trigeminal Neuralgia
Trigeminal neuralgia is a chronic pain condition characterized by recurring episodes of extreme, sporadic, sudden burning or electric shock-like face pain. The pain typically involves the lower face and jaw, although sometimes it affects the area around the nose and above the eye. In almost all cases, the pain is felt on one side of the face. Although the pain seldom lasts more than a few seconds or a minute or two per episode, the intensity of pain can be physically and mentally incapacitating. Trigeminal neuralgia is also called tic douloureux.
Trigeminal neuralgia most often affects people over the age of 50, however it can occur at any age. Trigeminal neuralgia is more common in women than in men, although the reason for this is unknown. There is some evidence that the condition may be inherited, possibly due to an inherited pattern of blood vessel formation.
The attacks can be triggered by vibration or contact with the cheek such as occurs during shaving, brushing teeth, eating, drinking, talking, or even as a result of exposure to wind. The attacks often worsen over time, with fewer and shorter pain-free periods between episodes. Some patients experience a tingling or numbing sensation in the days preceding an attack.
Causes of Trigeminal Neuralgia
Trigeminal Neuralgia is caused by irritation of the fifth cranial nerve. The trigeminal nerve is the fifth of 12 pairs of cranial nerves in the head. The condition may be part of the aging process but in some cases it is the associated with another disorder, such as multiple sclerosis or other disorders characterized by damage to the myelin sheath that covers certain nerves.
Some possible causes for trigeminal neuralgia are:
- Blood vessels pressing down on the trigeminal nerve
- Growths or lesions at the base of the skull
- Tumors
A variety of tests may be performed to identify problems and rule out other causes for the pain. These tests may include Magnetic resonance imaging (MRI), CT Scans, or X-rays. MRI's can detect if a tumor or multiple sclerosis is irritating the trigeminal nerve, however often imaging of the brain will not reveal the precise cause of the pressure.
Although drugs are sometimes effective in treatment, surgery may be required for permanent relief from the pain. Surgery is considered effective for cases that do not benefit from medications.
Watch surgical video of a trigeminal neuralgia operation.
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