Trigeminal Neuralgia (TN)

Trigeminal Neuralgia is a chronic pain condition that affects the trigeminal nerve, responsible for transmitting sensations from the face to the brain. This condition is considered rare, with approximately 12 cases per 100,000 people in the United States annually.

The trigeminal nerve is composed of two separate nerves, one on each side of the face. Each nerve has three branches: the forehead, midface, and chin. Trigeminal Neuralgia (TN) can affect any or all of these branches, causing intense pain in specific areas or throughout the entire face. The pain is typically unilateral and can be triggered by sounds or touch.

Common triggers and symptoms of Trigeminal Neuralgia include:

• Brushing your teeth
• Shaving
• Touching your face
• Eating or drinking
• Applying makeup
• Feeling a breeze on your face
• Speaking

Episodes of pain in TN can manifest as sharp spasms resembling electric shocks. These bouts of pain may last for a few seconds or minutes. Periods of attacks can persist for days, weeks, or months, followed by periods of remission. Over time, the severity and frequency of the pain may increase, and in some cases, the discomfort can become constant.

The causes of Trigeminal Neuralgia can include a swollen blood vessel or tumor exerting pressure on the nerve. It can also be associated with Multiple Sclerosis, a condition that damages the protective coating (myelin sheath) around nerves. However, in many cases, the exact cause of TN remains unknown. The condition is more prevalent in women and individuals over the age of 50.

To diagnose Trigeminal Neuralgia, a doctor will assess the type and location of pain, as well as the triggering factors. This evaluation will involve reviewing your medical history, conducting a physical examination, and performing a neurological exam. Additional tests may be ordered to rule out similar conditions like cluster headaches or postherpetic neuralgia, which affects nerve fibers and skin. An MRI of the head may be recommended to investigate if multiple sclerosis is contributing to the pain.

Treatment options for Trigeminal Neuralgia include:

• Medications: Anti-seizure medications that block nerve firing, muscle relaxants, and tricyclic antidepressants.
• Surgeries: These may involve glycerol injections, where sterile glycerol is injected through the cheek into the base of the skull; stereotactic radiosurgery, which delivers focused radiation beams to the root of the nerve using computer imaging; radiofrequency thermal lesioning, which guides an electrical current into the trigeminal nerve using a hollow needle; and Gamma-Knife radiosurgery, a minimally invasive option that uses targeted radiation to destroy the trigeminal nerve. Microvascular decompression is another surgical procedure that involves relieving pressure on the affected nerves through brain surgery, allowing them to heal.
• Complementary Therapies: Acupuncture and nutritional therapy may offer symptom relief, but it’s crucial to consult with a doctor before pursuing alternative treatments.

Proper treatment is vital for managing Trigeminal Neuralgia. If you experience symptoms of TN, consult with a medical professional to determine the most appropriate course of action for your situation.