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Trigeminal Neuralgia - Symptoms and Treatment


TN (Trigeminal Neuralgia) is a pain that is described as among the most acute known to mankind. Trigeminal Neuralgia (TN), also known as Tic Douloureux, is considered by many to be the "most terrible pain known to man." The condition is characterized by pain often accompanied by a brief facial spasm or tic. TN (Trigeminal Neuralgia / tic douloureux) is a disorder of the fifth cranial (trigeminal) nerve that causes episodes of intense, stabbing, electric shock-like pain in the areas of the face where the branches of the nerve are distributed - lips, eyes, nose, scalp, forehead, upper jaw, and lower jaw.  TN is known to exist in many younger individuals including children.

Symptoms of Trigeminal Neuralgia

Trigeminal Neuralgia disease Pain is brief and paroxysmal, but it may occur in volleys of multiple attacksand also pain is stabbing or shocklike and is typically quite severe. The electric shock-like pain generally is on one side of the face and is spasmodic, coming in short bursts lasting a few seconds. The severe trigeminal neuralgia have described the pain as:

  • Lightning-like or electric-shock-like
  • Shooting
  • Jabbing
  • Like having live wires in your face

Causes of Trigeminal Neuralgia

The condition is called trigeminal neuralgia because the painful facial areas are those served by one or more of the three branches of your trigeminal nerve.There are number of causes are includes

  • Pressure of a blood vessel on the root of the trigeminal nerve.
  • Demyelinization of the nerve. In rare instances (less than 3%), TN is a symptom of Multiple Sclerosis which destroys the myelin sheaths protecting nerve fibers. Trigeminal Neuralgia is rarely the first symptom of Multiple Sclerosis and typically appears in advanced stages of MS.
  • Pressure of a tumor on the trigeminal nerve (rare)
  • Physical damage to the nerve caused by dental or surgical procedures, injury to the face or infections.
  • Unknown. Not all cases seem to have a clear cause.
  • There is some speculation that some cases of trigeminal neuralgia may be inherited.

Treatment of Trigeminal Neuralgia

Medications are the usual initial treatment for trigeminal neuralgia. Initial treatment of TN is usually by means of anti-convulsant drugs, such as Tegretol or Neurontin. A number of drugs are available.the treatment list are below

  • Initial treatment for TN is usually medication with cabamazepine being the first drug of choice.
  • Baclofen is a muscle relaxant. Its effectiveness may increase when it's used in combination with carbamazepine or phenytoin.
  • Phenytoin, another anticonvulsant medication, was the first medication used to treat trigeminal neuralgia. Side effects include gum enlargement, dizziness and drowsiness.
  • Anticonvulsant drugs are common medications used to treat trigeminal neuralgia
  • Alcohol injections under the skin around the branches of the trigeminal nerve may offer temporary relief by numbing the areas for days or months
  • Infusion of phenytoin is reportedly successful in interrupting such episodes, but the value of this therapy is anecdotal.
  • Coordinate therapy for refractory pain of TN with the primary care physician or consultants.

 


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