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The trigeminal nerve is the largest cranial nerve that emerges from the brain and splits into three branches in the face; the ophthalmic, maxillary and mandibular branches and allows you to feel the sensations on the face and control chewing. these 3 branches meet at the trigeminal ganglion in your head. We have 2 trigeminal nerves on each side of the face
Trigeminal neuralgia is a chronic condition characterized by sudden, severe, shock-like facial pain coming from the trigeminal nerve, which starts near the top of the ear and divides in three, toward the eye, cheek and jaw.
Trigeminal neuralgia is also known as tic douloureux, which means “painful tic.”
Typically it affects on only one side of the face, but rarely can affect on both sides
There are 2 types:
This is a relatively uncommon condition affecting about 1.5 lakhs people every year. Trigeminal neuralgia typically affects people more than 50 years of age. Females are commonly affected more than males . It is considered a rare disorder.
It is typically caused when a blood vessel becomes enlarged or lengthened and compresses this nerve root near your brain stem. There are several conditions that may cause trigeminal neuralgia.These are :
Patients will suffer from episodes of excruciating pain at the slightest stimuli, affecting any area on only one side of the face, implicating only one of the trigeminal nerve pair as the cause. Rarely, Pain can occur on both sides of the face. These episodes are short lived, lasting from from a few seconds to minutes. There will be pain-free breaks in between the episodes
Simple activities that require you to move or touch your face can trigger brief bouts of severe pain, which are short lived, the pain can recur on & off. These includes:
After complete medical history taken, doctor will perform the comprehensive neurological examination. The physician will advice magnetic resonance imaging (MRI) scan to rule out brain tumors, MS and other potential causes. The scan can also detect whether there’s a blood vessel pressing on the nerve that is causing pain.
Most of the time over-the-counter pain medicines don’t work for people with trigeminal neuralgia, but many advance treatments can reduce or eliminate the pain. The doctor may advice one or more of these approaches:
Medications like antineuropathic medications to reduce or block the pain signals sent to your brain.
Non-Surgical Pain Management Interventions:
These procedures are used to treat trigeminal neuralgia, such as a rhizotomy. In a rhizotomy, your physician destroys nerve fibers to reduce pain, and this causes some facial numbness. Types of rhizotomy include:
When is Surgery Indicated?
If you don’t respond to any of these medications or your pain is worsening over time, you could be a candidate for surgery.
Surgical options for trigeminal neuralgia include:
Microvascular decompression & Brain stereotactic radiosurgery (Gamma knife).