Trigeminal neuralgia, also known as TN, is a chronic pain condition that affects the trigeminal nerve file view. The trigeminal nerve is a group of nerves, responsible for carrying sensations from your face to your brain. Each trigeminal nerve is made up of three branches that control the feelings for different parts of your face.
- The ophthalmic branch controls your eye, upper eyelid, and forehead.
- The maxillary branch affects your lower eyelid, cheek, nostril, upper lip, and upper gum.
- The mandibular branch runs through your jaw, lower lip, lower gum, and some muscles you use for chewing.
With trigeminal neuralgia, any stimulation to your face, including mild ones like the movement of brushing your teeth or applying make-up, triggers agonising pain. Some people describe this pain as a “shock in the face”. The condition affects any of the three nerves, meaning that you can feel discomfort anywhere from your forehead to your jaw.
The condition starts with short, mild attacks and can gradually trigger longer, more frequent ones resulting in excruciating pain. TN affects women more often than men, and it’s more likely to occur in people older than 50.
Symptoms of trigeminal neuralgia:
- Periods of stabbing or shooting twinges that last anything from a few seconds to several minutes.
- Pain that affects only one side of your face.
- Pain felt mostly in your jaw, cheek, lips and gums.
TN can be a signal of several underlying conditions. One of the most common reasons that it develops is when a blood vessel presses on the trigeminal nerve as it exits the brain’s stem. This ongoing compression wears away and damages the protective coating (the myelin) that surrounds the nerve. TN is common in people who have multiple sclerosis, a disease where the trigeminal nerve’s myelin sheath is deteriorated. An injury to the trigeminal nerve, like from a stroke, sinus surgery, or facial trauma can also result in TN.
Your doctor may prescribe you medication, called anticonvulsants, which helps prevent these nerves from reacting when they’re irritated. Muscle relaxants are also helpful, along with tricyclic antidepressants to manage your symptoms.
Medication can lose its effect over time. If this happens, there are several surgery options that your doctor could suggest:
- Gamma knife radiosurgery
Uses radiation focused on the trigeminal nerve.
- Microvascular decompression
Moves or takes out blood vessels that are affecting the nerve.
Destroys nerve fibres.
Involves cutting a part of the nerve. It’s usually performed near the entrance point of the nerve at the brain’s stem provided there is no vessel pressing against the trigeminal nerve. This surgery is also done by cutting superficial branches of the nerve in the face. However, if the operation is performed in your face, there’s a possibility that the nerve might grow back. That means the painful sensations may return.