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Trigeminal neuralgia (TN) is a chronic pain condition that affects the nerve in the head that carries sensation from your face to your brain, otherwise known as the trigeminal nerve. If you have trigeminal neuralgia, even a light touch of your face such as brushing your teeth, eating or washing your face may trigger a jolt of excruciating pain.
This condition is characterised by sudden and severe pain in one side of the face, likened to ‘electric-like pain’.
What are the types of trigeminal neuralgia?
Trigeminal neuralgia can be classified into two main types:
Classical trigeminal neuralgia. This type is characterised by sudden, severe, and brief episodes of facial pain that last from a few seconds to a couple of minutes. The pain is often likened to ‘electric shocks’ or ‘stabbing’ and can be triggered by touch or movement. The cause is often due to a blood vessel inside the brain that is compressing the trigeminal nerve.
Secondary trigeminal neuralgia. This type is due to an identifiable underlying disease, such as multiple sclerosis, a tumor or other causes. These conditions directly affect the trigeminal nerve resulting in sensitivity and pain.
What are the symptoms of trigeminal neuralgia?
The symptoms of trigeminal neuralgia include:
Sudden, intense, sharp pain that feels like an electric shock.
Pain episodes that last from a few seconds to two minutes and can occur in quick succession.
Pain triggered from touching the face, chewing, speaking, brushing teeth, or exposure to wind.
Pain that typically affects one side of the face, commonly the cheek, jaw, teeth, gums, lips, or less often the eye and forehead.
Pain episodes occur periodically when triggered. Some patients go into remission that may last for days, weeks, months, or longer.
What causes trigeminal neuralgia?
Trigeminal neuralgia is caused by the irritation of the trigeminal nerve. The underlying cause is determined by the type of trigeminal neuralgia:
Classical trigeminal neuralgia. This type is due to a blood vessel pressing on the trigeminal nerve as it exits the brainstem, causing the nerve to malfunction.
Secondary trigeminal neuralgia. This type can be caused by different underlying causes such as multiple sclerosis (which damages the myelin sheath that protects the nerves.) Tumors can also contribute to this type of neuralgia by compressing the trigeminal nerve. Additionally, facial trauma or injuries resulting from surgery may lead to this painful condition. Other contributing factors include arteriovenous malformations (AVMs) and aneurysms, both of which can disrupt normal nerve function.
Idiopathic trigeminal neuralgia. This category is used when no clear cause can be identified. It is diagnosed when neither neurovascular compression nor other secondary causes are evident.
What are the risk factors of trigeminal neuralgia?
Several factors may increase the risk of developing trigeminal neuralgia:
Age. More common in people over 50 years old.
Gender. Women are more likely to develop trigeminal neuralgia than men.
Genetics. Family history of trigeminal neuralgia.
What are the complications and related diseases of trigeminal neuralgia?
Complications and related diseases include:
Chronic and severe pain that can significantly impact daily activities and quality of life.
Depression and anxiety due to chronic pain and the stress of dealing with the condition.
Weight loss and malnutrition due to difficulty eating as a result of the pain.
Medication side effects such as dizziness, drowsiness, and liver damage from long-term use of pain medications.
Related diseases such as multiple sclerosis that can cause or coexist with trigeminal neuralgia.
How do you prevent and manage trigeminal neuralgia?
While trigeminal neuralgia cannot always be prevented, certain measures can help reduce the risk or manage the condition:
Identify and avoid specific triggers that can precipitate pain episodes.
Maintain a balanced diet, regular exercise, and stress management techniques.
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