TRIGEMINAL NEURALGIA

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Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain. If you have trigeminal neuralgia, even mild stimulation of your face — such as from brushing your teeth or putting on makeup — may trigger a jolt of excruciating pain.

You may initially experience short, mild attacks, but trigeminal neuralgia can progress, causing longer, more frequent bouts of searing pain. Trigeminal neuralgia affects women more often than men, and it’s more likely to occur in people who are older than 50.

Because of the variety of treatment options available, having trigeminal neuralgia doesn’t necessarily mean you’re doomed to a life of pain. Doctors usually can effectively manage trigeminal neuralgia with medications, injections or surgery.

SYMPTOMS


Trigeminal neuralgia symptoms may include one or more of these patterns:

Occasional twinges of mild pain

Episodes of severe, shooting 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

Pain affecting one side of your face at a time

Bouts of pain lasting from a few seconds to several seconds

Pain in areas supplied by the trigeminal nerve (nerve branches), including the cheek, jaw, teeth, gums, lips, or less often the eye and forehead

Pain focused in one spot or spread in a wider pattern

Attacks becoming more frequent and intense over time

Episodes of several attacks lasting days, weeks, months or longer —some people have periods when they experience no pain

CAUSES


In trigeminal neuralgia, also called tic douloureux, the trigeminal nerve’s function is disrupted. Usually, the problem is contact between a normal blood vessel — in this case, an artery or a vein — and the trigeminal nerve, at the base of your brain. This contact puts pressure on the nerve and causes it to malfunction.

Trigeminal neuralgia can occur as a result of aging, or it can be related to multiple sclerosis or a similar disorder that damages the myelin sheath protecting certain nerves. Less commonly, trigeminal neuralgia can be caused by a tumor compressing the trigeminal nerve. In other cases, a cause can’t be found.

TRIGGERS


A variety of triggers may set off the pain of trigeminal neuralgia, including:

Shaving

Stroking your face

Eating

Drinking

Brushing your teeth

Talking

Putting on makeup

Encountering a breeze

Smiling

TESTS AND DIAGNOSIS


A diagnosis of trigeminal neuralgia is primarily based on a description of your pain, including the:

  • Type. Pain related to trigeminal neuralgia is sudden, shock-like and brief.
  • Location. The parts of your face that are affected will tell your doctor if the trigeminal nerve is involved.
  • Triggers. Trigeminal neuralgia-related pain is typically brought on by light stimulation of the cheeks, such as from eating, talking or even encountering a cool breeze.

Tests used to confirm the diagnosis may include:

  • A neurological examination. Touching and examining parts of your face can help your doctor determine exactly where the pain is occurring and — if you appear to have trigeminal neuralgia — which branches of the trigeminal nerve may be affected.
  • Magnetic resonance imaging (MRI). An MRI scan of your head can show if multiple sclerosis is causing trigeminal neuralgia.
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