What is Trigeminal Neuralgia?
Trigeminal neuralgia (TN) is a rare but incredibly painful disorder. Characterized by intermittent electrical
facial pain, trigeminal neuralgia can affect anyone, but it is more common in women than men and most often affects people aged 50 and older. Impacting roughly 200,000 Americans, trigeminal neuralgia has been called one of the most excruciatingly painful disorders. It can range from intermittent, mild symptoms to frequent and debilitating pain.
While trigeminal neuralgia can often be mistaken for other types of facial pain, when properly diagnosed, 75 percent of trigeminal neuralgia sufferers find relief with medication, while 25 percent require surgery.
Trigeminal neuralgia is also referred to as tic douloureux. Several categorizing systems for facial pain have become popular in the mainstream, such as TN types 1 or 2. This can be confusing to patients when it doesn’t need to be. Basically, there are two primary types of facial pain: trigeminal neuralgia and trigeminal neuropathy (also often called atypical facial pain). The key to diagnosis lies in the nature of the pain, its constant or intermittent presence, and its potential to be triggered by common stimuli such as eating or talking. There appears to be a spectrum between classically described trigeminal neuralgia and neuropathic facial pain, and although these two entities are very different, many people lie somewhere on the spectrum between them.
Causes of Trigeminal Neuralgia
Trigeminal neuralgia, often called TN, can originate from a variety of conditions and has been linked to hypertension and multiple sclerosis. Trigeminal neuralgia is usually caused by a blood vessel at the base of the brain pressing against the trigeminal nerve, the largest cranial nerve responsible for sending impulses including pain, pressure, touch, and temperature to the brain from the face, jaw, gums, forehead, and around the eyes. Over time, changes in the blood vessels of the brain can result in a blood vessel sagging and rubbing against the trigeminal nerve root. The constant rubbing with each heartbeat wears away the insulating membrane of the nerve, setting up a “short circuit” that results in facial pain.
Trigeminal neuralgia also, in rare cases, can be caused by compression of the nerve by a tumor or vascular malformation. In multiple sclerosis, a demyelinating plaque near the nerve’s entry into the brain can cause trigeminal neuralgia.
Symptoms of Trigeminal Neuralgia
Trigeminal neuralgia, or TN, symptoms include:
- a sudden, severe shock-like or stabbing pain
- pain is typically felt on only one side of the face
The attacks of pain can be cyclical and are unique to each sufferer, varying in length of attack and frequency of occurrences, ranging from pain experienced daily or monthly to pain that disappears for months or years. Trigeminal neuralgia pain is never constant.
The pain can permeate a small or larger part of the face and can sometimes be felt around the lips, eyes, nose, scalp and/or forehead. Trigeminal neuralgia symptoms are typically triggered by contact with the face, such as when you are brushing your teeth, putting on makeup, touching your face, swallowing, or even when you feel a slight breeze, or when water hits your face in the shower.
Signs you may have trigeminal neuralgia:
- “Shock-like” pain that comes and goes suddenly
- Pain that occurs in cycles and may disappear for months or years
- Pain on one side of your face (although pain on both sides can also, rarely, be trigeminal neuralgia)
- Pain that is triggered by a touch or breeze to the face or eating/talking