Overview

What is Trigeminal Neuralgia?

Trigeminal neuralgia (TN), or Tic Douloureux, ( also known as prosopalgia ) is a neuropathic disorder that affects the trigeminal nerve that causes severe pain to various parts of the body such as the lips, nose, jaw, eyes, forehead and scalp. The pain is often described as a jab of quick pain that will shoot through your head. The pain is often localized to one side of the face and it happens frequent and at can be very unbearable. Because of the intense pain, trigeminal neuralgia was often called the suicide disease, due to the high rate of suicide of people who had the condition and could not stand the pain anymore.

In the beginning you might experience short and mild attacks. However over time trigeminal neuralgia can progress resulting in longer and more frequent episodes of pain. The pain attack can be spontaneous but they can also be initiated by simple events such as brushing your teeth, putting on makeup or shaving. Trigeminal neuralgia will often begin in the small part of the face, but will eventually start to spread all over your face and cover a wider area. It is estimated one in 15,000 people suffers from trigeminal neuralgia. This number however might be higher due to the misdiagnosis of the condition. It is known to develop in older people in their 40’s, however there have been cases where it has affected children as young as 3.

Trigeminal neuralgia is often wrongly diagnosed as a dental problem. As a result, many people who suffer from this disease often have tooth extractions and oral surgery to try and prevent the pain. Because it was misdiagnosed the pain would still exist. This is because the pain is coming from the trigeminal nerve and not the tooth. In the patient’s case, they can go extended periods of pain until they are properly diagnosed.

The trigeminal nerve is the fifth cranial nerve. This nerve is responsible for carrying sensory data such pressure, temperature and pain that will originate from the face above the jaw. The mixed cranial nerve is also responsible for motor functions such as chewing.

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, either with medications or surgery.

What Causes 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. This large nerve originates deep inside your brain and carries sensation from your face to your brain. The pain of trigeminal neuralgia is due to a disturbance in the function of the trigeminal nerve. Trigeminal neuralgia is also known as tic douloureux.

The cause of the pain associated with trigeminal neuralgia is usually a result of contact between a normal artery or vein and the trigeminal nerve that is located at the base of your brain. The result of this is added pressure that will be placed on the nerve as it enters your brain. This pressure will result in the nerve misfiring. Physical nerve damage or stress may be the initial trigger for trigeminal neuralgia.

Once the trigeminal nerve leaves your brain and travels through your skull, it becomes divided into three smaller branches. These branches become responsible for controlling the sensations throughout your face.

Branch 1 – This branch is responsible for the sensations in your eye, upper eyelid and forehead.

Branch 2 – This branch is responsible for the sensation in your lower eyelid, cheek, nostril, upper lip and upper gum.

Branch 3 – This branch is responsible for the sensations in your jaw, lower gum, lower lip and some of the muscles you use for chewing.
Depending on the branch, you might feel pain, regulated to that area or the pain from trigeminal neuralgia might affect the entire side of your face.
Besides compression from blood vessel contact, other less frequent sources of pain to the trigeminal nerve may include:

Multiple sclerosis

Compression by a tumor

A stroke affecting the lower part of your brain, where the trigeminal nerve enters your central nervous system

There are other triggers that may set off the pain in trigeminal neuralgia. They are very subtle actions that can often result in triggering the pain sensations. These are listed below.

Shaving

Stroking your face

Eating

Drinking

Brushing your teeth

Talking

Putting on makeup

Encountering a breeze

Smiling

The trigeminal neuralgia disease affects women more often than men. It will also will also likely occur in people who are older than 50. There have been cases where it has been diagnosed in children 3 years old. It has been shown that up to 5% of people who have condition will also have family members with it. There is a possible genetic link as a result of this.

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