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A Trigeminal neuralgia (TN), also called tic douloureux, is a condition that is characterized by intermittent, shooting pain in the face.
Fig : Trigeminal Neuralgia
Causes of Trigeminal Neuralgia
- Pressure of a blood vessel on the root of the trigeminal nerve.
- 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
- 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.
- Over time, changes in the blood vessels of the brain can result in a blood vessels rubbing against the trigeminal nerve root.
Symptoms Symptoms of Trigeminal Neuralgia
The episodes of pain occur paroxysmally, or suddenly.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 pain sometimes gets worse or better for periods of weeks or months.
The pain is in the areas supplied by the trigeminal nerve :
Cheeks,
Jaw,
Teeth,
Gums,
Lips and
Less often around the eye or forehead.
Diagnosis of Trigeminal Neuralgia
Trigeminal neuralgia usually is diagnosed based on the patient's description of the symptoms. Magnetic resonance imaging (MRI) can be used to determine whether a tumor or multiple sclerosis is irritating the trigeminal nerve. Often when the MRI is performed, some contrast material is injected into the vein so that the appearance of a small tumor, blood vessel, or other structures in the brain can be enhanced and made easier to detect.
Treatment of Trigeminal Neuralgia
If medication fails to relieve pain or produces intolerable side effects such as excess fatigue, surgical treatment may be recommended. Several neurosurgical procedures are available.
There are five important neurosurgical procedures. Each is effective, but not always, and occasionally has to be repeated. These procedures are :
The common treatments for Neurosurgery are as follows :
Glycerol Injection
Microvascular Decompression
Balloon Microdecompression
Stereotactic Radio Surgery
Percutaneous Steriotactic Radiofrequency Rhizotomy – Electrocoagulation
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