Trigeminal neuralgia is a condition in which a person experiences intermittent shooting pains within the face. It occurs when there is a disruption of normal function in the trigeminal nerve, which sends electrical impulses of pain, pressure, temperature, and touch to the brain from the jaw, face, gums, and around the eyes.
The disruption is caused by compression or damage to the trigeminal nerve, usually due to contact between the nerves and a nearby blood vessel. This contact places pressure upon the nerve, which leads to malfunction and pain.
In most cases, the disorder begins as short mild attacks. Over time, these attacks can last longer and become more frequent as well as becoming more painful. Though rare, the pressure may be due to the presence of a tumor.
Patients often experience jolts of excruciating pain as a response to even the most minimal stimulation. Common triggers include eating, shaving, drinking, talking, smiling, and encountering a breeze. Trigeminal neuralgia is more often seen in women and rarely occurs in people younger than 50 years old.
The most notable symptom of trigeminal neuralgia is the sharp shooting pain in the face when stimulation is applied. Pain may range from mild to severe and can also be present in the mouth.
Patients might also experience an uncomfortable burning or tingling sensation or over sensitivity as well as painful spasms within the facial muscles.
Chronic pain that affects the trigeminal nerve is clinically known as Trigeminal Neuralgia (also TN or TGN), and there are several theories as to the cause of this condition. However, it should be noted that none of these have been fully proven to be the exact cause.
The most recent of this research seems to indicate that an enlarged (or perhaps lengthened) blood vessel compresses or throbs against the trigeminal nerve at its pons connection. The most likely blood vessel to do this would be the superior cerebellar artery. Damage to the nerve’s protective myelin sheath will make the function of the nerve both hyperactive and erratic in nature so that the slightest stimulation can be extremely painful to the sufferer.
Also, the pain signals may not be able to be shut off by the nerve as is generally done in a healthy nerve, and this can mean lingering pain even after the stimulation has ceased. Things such as aneurysms, tumors, and traumatic injuries can all lead to this condition. Multiple Sclerosis sufferers have been shown to have Trigeminal Neuralgia in about 3 to 4% of that population, and the latest theories in that regard point to damage to the spinal trigeminal complex as the likely culprit.
Finally, there are some instances of Trigeminal Neuralgia where there is no apparent structural cause that can be blamed, and in this type of manifestation it is known as the idiopathic variety.
Mild cases of trigeminal neuralgia may not require medical treatment until symptoms become problematic. When it reaches that point, a doctor can prescribe various medications such as antispasmodic agents, anticonvulsants, and Botox injections.
Severe cases may require surgery to correct whatever is compressing or damaging the nerve, although this is not always guaranteed to be a permanent solution for everybody.
TN is so often misdiagnosed, and there still is much to be researched in order to determine whether it is at all possible to prevent the condition.
However, it has certainly been shown that quick and effective medical management can limit the further degradation of the nerve and pathways which will not be reversible.