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Trigeminal Neuralgia

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Trigeminal Neuralgia related image Photo: Getty Images

Trigeminal neuralgia is a dysfunction of the trigeminal nerve (the fifth cranial nerve in the brain), characterized by severe shooting, burning and stabbing pain in the face. Areas affected include the forehead, eyes, cheeks and jaw. The pain comes and goes in bouts and is usually very bad when it occurs.

What Causes Trigeminal Nerve Dysfunction?

Trigeminal neuralgia can be the result of aging, as most people with the condition are over the age of 50 (although it can happen in younger people).

It can also be caused by demyelination (where the protective covering of the nerves erodes away, leaving them exposed). This leads the nerves to transmit pain signals when there is no reason to feel pain. Around 4 percent of people with trigeminal neuralgia are found to have multiple sclerosis (MS). If you have MS you are at increased risk of having this type of neuralgia.

Other causes include:
Trauma--for instance, a car accident causing injury to the nerves.
Tumors--a tumor may press on the nerves and cause trigeminal neuralgia.
It can also be an after-effect of having shingles.

What Treatments are there for Trigeminal Neuralgia?

The first line treatment is anti-convulants. These shut down the nerves over time and stop the pain. It is thought when the medication is tapered off, the nerves can regenerate normally. Anti-depressants may be used instead for the same effect.

If you have severe side-effects from either of these drugs or if they are contraindicated, there are non-drug options, such as:
• Glycerol injection. This injection is given under sedation. It is given through the cheek. The glycerol kills the nerve endings so they are unable to transmit pain.
• Radiofrequency Rhizotomy – the nerve is heated to kill the nerve endings.
• Cryotherapy – the nerve is frozen.
• Surgery.
If you have the glycerol injection, radiofrquency treatment or cryotherapy, it may leave your face feeling numb afterward. The procedures aren’t life-long and may provide relief for only a few months, but possibly up to a few years. However, they can be repeated if you find the pain is coming back.

Surgery – called microvascular decompression – is when a surgeon makes a small cut behind the ear, inserts an operative microscope and then moves blood vessels away from the trigeminal nerves and places a cushion in between them to stop the problem re-occurring. This is the most effective form of treatment and most patients have immediate relief from pain after their surgery; however, some patient's symptoms re-occur. But overall, 75 percent of patients were still pain-free five years later.

There is a small risk of having a stroke after this surgery, but your neurologist should be able to discuss with you whether you are a suitable candidate for this operation.

Stereotactic radiosurgery is another option. This is where radiation beams are fired directly at the base of the nerve to kill it. If you live in the UK, your access to this treatment may be limited as it is currently only available in three hospitals there.

Emotional Support

Your doctor should refer you for counseling as this type of neuralgia causes severe pain, and since it is usually a long-term condition, it can be very difficult to cope with and many patients suffer depression as a result.

Source: http://www.tna.org.uk/data/files/Pamphlets/trigeminal_neuralgia__an_overview__february_20111.pdf

Joanna is a freelance health writer for The Mother magazine and Suite 101 with a column on infertility, http://infertility.suite101.com/. She is author of the book, 'Breast Milk: A Natural Immunisation,' and co-author of an educational resource on disabled parenting, in addition to running a charity for people damaged by vaccines or medical mistakes.

Add a Comment2 Comments

There are also other support means:


The facial pain organization: www.endthepain.org

March 21, 2011 - 5:40pm

Thank you for writing about Trigeminal Neuralgia (TN) and bringing the awareness out. I do not think that you have a complete grasp of the life of a person who suffers from TN.

I have had TN for 8.5 years. Many meds, 4 MVD's, DREZ and other alternative treatments. At the risk of sounding like I need counseling, you make it sound like the pain is in our mind. I am 21, so I have dealt with the pain for years. It does make you down, frustrated, helpless, angry etc, but I for one do not appreciate when people tell me to go see a psychologist. It is NOT IN OUR MIND. THIS IS CALLED THE SUICIDE DISEASE, BECAUSE THE PAIN IS SO UNBEARABLE. There have been times where I am flailing all over the bed, or the pain makes me drop to my knees. Going to a psychologist will NOT make this pain go away. And the psychologists, just like many other people DO NOT UNDERSTAND.

You have offended me and many other people who are in pain. Every aspect of our life has to change. I have had TN since I was 13, so I have NEVER been able to experience a "normal life." Going to a psychologist is not going to give me my high school years back, nor is it going to make me graduate college faster. It is just going to make me angry that yet again, someone just wants to boo hoo me and take my money.

Some of your medical suggestions were valid. Other information was not. Where did you get the suggestion of counseling? Let's look at it differently. Do you get migraines? Multiply that by 10 and then try and drive, eat, talk, shower, go outside, go to work, and enjoy life. Not so easy. Is a psychologist going to make your migraine any better? I think not!

Please be more considerate next time you plan to write about the suicide disease- did you know it was called that too?

I pray each day that this terrible pain with just let me be, or that someone will have an answer. But you can not understand that unless you have the pain. So please, next time, think about your audience.

March 21, 2011 - 5:27pm
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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