Trigeminal Neuralgia: Its Properties And Treatment

Most people find trigeminal neuralgia to be one of the most painful conditions a person can experience.  Sometimes it is even a direct cause of suicide. It is caused by a disorder of the cerebral nerve that unleashes a violent electric shock in response to small and normal things such as: talking, eating, temperature changes, and so on.

It’s not just a headache or a migraine. People who are so unlucky that they have to live with trigeminal neuralgia know that painkillers are of no use. Often, even morphine cannot relieve pain.

When this happens, only  antiepileptic drugs can allow a person suffering from this to live a more or less normal life. But what they get in exchange are the side effects that these medications bring with them.

To outsiders, their pain may seem exaggerated. But this disease is not unnecessarily called a “suicide disease.” This disease was first classified in 1672, but there are other examples of this disease that go back much further in time.

They describe this disease as the most crippling, most severe pain anyone can experience. Today, an estimated 8-12% of the world’s people suffer from trigeminal neuralgia. It is a chronic disease, but there may still be some treatments for it.

What is trigeminal neuralgia?

The origin of trigeminal neuralgia is in one-fifth of our twelve cerebral nerves. This nerve is the largest nerve in our head. Next, we will review its structure to gain a better understanding of how it radiates this pain.

• This nerve has three branches. The first is the optic nerve, or upper arm,  which causes a painful sensation that can pass from the scalp to the other side of the forehead, along with either eye that is on the same side.
• Next is the upper jaw nerve, or middle branch, which stimulates the cheeks, upper jaw,  upper lip, teeth, upper gums, and the other side of the nose.
• Last is the lower jaw nerve, or lower arm. This causes painful sensations in the lower jaw,  teeth, lower lip and lower gums.

People with trigeminal neuralgia usually feel pain only on one side of their face. But there is also a rare condition called bilateral limb pain that makes this even worse. This basically means that the victim experiences trigeminal neuralgia on both sides of the head.

What are the symptoms of trigeminal neuralgia?

Symptoms associated with trigeminal neuralgia vary between patients. One thing they all share are “trigger areas.” These include areas that respond to severe pain. The pain is like a strong electric shock that can last from a few seconds to two hours.

• Small activities such as touching the face can be painful.
• Changes in temperature, chewing, talking, and grinding your teeth can cause crippling pain.
• The pain travels a path that may begin at the head and move to the other eye, ear, and finally all the way to the lower jaw. 
• After this powerful electric shock,  people are usually unable to do anything for an hour or two. They are unable to eat, drink or even open their eyes. They have to wait for the nerve to calm down slowly.

Causes of trigeminal neuralgia

There is not just one cause of trigeminal neuralgia. This farm actually has a wide range of factors involved. Let us now look at a few of these to better understand the complex reality of this state.

• In general, it is genetic.
• As magnetic resonance imaging has shown,  often a blood vessel pushes the trigeminal nerve out of the brainstem. This compression then leads to the degradation of myelin, i.e. the weakening of the protective layer of this nerve. This is what makes these powerful electric shocks possible.
• In addition, we know that facial or oral surgery or paralysis caused by traumatic injuries can cause it.

• It is also important to make it clear that the root cause is often unknown. In other words, it is almost impossible to know exactly what exactly has led to the development of this disease.

Can it be treated?

We need to keep in mind that this neuropathic condition varies between individuals. There are people who experience this for two months in the tube, but then this condition disappears for a while. There are people who experience it every day, and people who experience it on both sides of the head. Some have managed to control the triggers and enjoy a better quality of life.

Therefore, the therapeutic approach must be individual to each person. But let’s look at some of the most common strategies:

• Antiepileptic drugs are usually the most effective in treating trigeminal neuralgia. Drugs such as carbamazepine, oxcarbazepine, and gabapentin are the most common of these.

• Tricyclic antidepressants such as amitriptyline and nortriptyline are common medications to relieve the pain caused by this disease.

Last resort: surgery

When medications do not work, the only option is surgery. Here are a few options that patients have before surgery:

• Rhizotomy:  Temporary damage to certain nerve tissues so that they no longer produce pain.
• Glycerol Injection: An  outpatient procedure that involves the tissues around the trigeminal nerve. This treatment lasts for at least two years.
• Radiofrequency Damage: An  outpatient procedure that uses an electrode to damage pain-producing nerve tissue. This is temporary, like a rhizotomy.

• Microvascular Decompression: The most penetrating (and most effective) of all surgeries. First, a small hole is made in the appendix (the bone behind the ear). A small balloon is then used to move the heavy blood vessel against the trigeminal nerve.

As we can see, there are many different ways to treat trigeminal neuralgia. Trigeminal neuralgia affects 8-12% of the world’s population, and we also know that  about 70-80% of patients respond well to medications. This means they never have to have surgery.