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Trigeminal Neuralagia

Trigeminal neuralgia or tic douloureux is a chronic pain condition that affects the trigeminal nerve in the face. The nerve carries sensations from face to the brain. The condition initially causes a jolt of excruciating pain that is intermittent, short and mild but can progress and cause longer, more-frequent bouts of searing pain.

Triggering factors of Trigeminal Neuralgia

Mild stimulation of face by any of the following can trigger the pain of trigeminal neuralgia:

  • Brushing teeth

  • Shaving

  • Touching or washing face

  • Putting on makeup

  • Chewing

  • Biting

  • Swallowing

  • Talking

  • Drinking

  • Smiling

Causes of Trigeminal Neuralgia

Trigeminal Neuralgia is caused by a disruption in the functioning of the trigeminal nerve. In most of the cases it occurs when a normal blood vessel (artery or vein) presses against the trigeminal nerve at the base of the brain. This pressure on the trigeminal nerve causes it to malfunction.

Other than this, following may also cause trigeminal neuralgia:

  • Aging as it is more likely to occur in people who are older than 50

  • Multiple sclerosis or similar disorders that damage the myelin sheath protecting certain nerves

  • Brain lesions or other abnormalities

  • Tumor compressing the trigeminal nerve

  • Surgical injuries

  • Stroke

  • Facial  trauma

  • Sometimes the cause remains unknown

Symptoms of Trigeminal Neuralgia

The symptoms of trigeminal neuralgia may include one or more of the following patterns:

  • Sudden, severe & stabbing facial pain that may last from a few seconds to several minutes

  • Pain may feel like an electric shock in areas supplied by the trigeminal nerve including around the cheek, jaw, teeth, gums, lips, or less often the eye and forehead

  • Usually the pain is localized to one side of the jaw or cheek but in some cases, it may occur at different places and at different times

  • Frequency of attacks may vary from 1 or 2 per day to almost 12 per hour reaching up to hundred times per day

  • Constant aching, burning feeling that’s less intense than the spasm-like pain

Diagnosis of Trigeminal Neuralgia

There are no specific tests to accurately determine the certainty of the condition and can mainly be diagnosed based on the description of symptoms specified by the patient including type, location and trigger of pain. Apart from this, following examinations and diagnostic tests may help the physician to diagnose the condition:

  • A thorough physical and neurological examination

  • MRI scans in cases where trigeminal nerve is irritated due to tumor or multiple sclerosis, can be used to diagnose trigeminal neuralgia

Authored By Dr. Manish Vaish

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