HYDERABAD: During the aging superior cerebellar artery elongates and compress the nerve causes demyliantaion of nerve, each pulsation transmitted from artery to nerve causes pain. These contribute 70 per cent cases. Veins compressing the nerve contribute 20 per cent. Artery and vein causing trigeminal neuralgia is more painful than others.
Some people may experience trigeminal neuralgia due to a brain lesion or other abnormalities. In other cases, surgical injuries, stroke or facial trauma may be responsible for trigeminal.
Symptoms
Initially it starts with lighter pain and develops in to constant aching, burning feeling that’s less intense than the spasm-like pain.
Over the period pain progress develops episodes of severe, shooting (excruciating pain) or jabbing pain that may feel like an electric shock, spontaneous attacks of pain or attacks triggered by things such as touching the face, chewing, speaking and brushing teeth, bouts of pain lasting from a few seconds to several minutes, episodes of several attacks lasting days, weeks, months or longer - some people have periods when they experience no pain.
Pain in areas supplied by the trigeminal nerve, including the cheek, jaw, teeth, gums, lips, or less often the eye and forehead.
Pain affecting one side of the face at a time, though may rarely affect both sides of the face.
Pain focused in one spot or spread in a wider pattern.
Attacks that become more frequent and intense over time.
Most commonly effected area are lower jaw and upper teeth start from ear region.
The worst pain
Trigeminal neuralgia (TN) is considered by many to be among the most painful of conditions of mankind, and was once labeled the “suicide disease” because of the significant numbers of people taking their own lives before effective treatments were discovered. The disease entity of Trigeminal Neuralgia has been known now for centuries. It is probably one of the worst kinds of pains known to man.
Treatment
Initially medical treatment like carbamazepine, baclofen relives the pain over the period medication stop reducing the pain.
If a patient experiences excruciating pain that does not reduce, this is an indication for surgery.
In Trigeminal nerve decompress, artery or vein is separated from nerve, and a small patch is placed between nerve and artery. Surgery relieves 90-100 percent and recurrence of the pain too is lesser.
If surgery is not possible because of comorbid features patient can go for radio frequency ablation.
(The author is a senior consultant neuro-surgery at Global Hospitals)
Does the pain occour all of a sudden or are there some triggers?