Overview
Trigeminal neuralgia is a chronic pain condition characterized by painful sensations similar to an electric shock on one side of the face. The pain is usually caused by the compression or irritation of the trigeminal nerve, which carries sensation from the face to the brain. Even mild stimulation of the face, such as from brushing teeth or putting on makeup, may trigger a jolt of excruciating pain. Symptoms may include episodes of severe, shooting or jabbing pain, attacks triggered by touching the face or other facial movements, and pain lasting from a few seconds to several minutes. Trigeminal neuralgia can progress and cause longer, more frequent bouts of pain, and may be managed through medications, injections, or surgery. If you experience facial pain, particularly prolonged or recurring pain, or pain unrelieved by over-the-counter pain relievers, it is recommended to see your doctor.
Understanding the disease
Symptoms
Symptoms of trigeminal neuralgia may include one or more of the following:
- Episodes of severe, shooting or jabbing pain that may feel like an electric shock
- Spontaneous attacks of pain or attacks triggered by things such as touching the face, chewing, speaking, or brushing teeth
- Attacks of pain lasting from a few seconds to several minutes
- Pain that occurs with facial spasms
- Bouts of multiple attacks lasting days, weeks, months, or longer
- Pain in areas supplied by the trigeminal nerve, including the cheek, jaw, teeth, gums, lips, or less often the eye and forehead
- Pain affecting one side of the face at a time
- Pain focused in one spot or spread in a wider pattern
- Pain rarely occurring at night while sleeping
- Attacks that become more frequent and intense over time If you experience facial pain, particularly prolonged or recurring pain, or pain unrelieved by over-the-counter pain relievers, it is important to see your doctor.
Development
Trigeminal neuralgia can develop due to a variety of causes, including compression by a blood vessel, multiple sclerosis, tumors, surgical injuries, stroke, or facial trauma. In trigeminal neuralgia, also called tic douloureux, the trigeminal nerve's function is disrupted, leading to painful sensations similar to an electric shock on one side of the face. The nerve's malfunction results from pressure on the nerve, which can be caused by various factors. While compression by a blood vessel is a common cause, there are many other potential causes for the condition.
Assessment and Diagnosis
Triage
If you experience facial pain, particularly prolonged or recurring pain, or pain unrelieved by over-the-counter pain relievers, you should see your doctor.
Diagnosis
To diagnose trigeminal neuralgia, your doctor will mainly rely on your description of the pain, including its type, location, and triggers. Additionally, your doctor may conduct various tests to determine the underlying causes, such as a neurological examination, magnetic resonance imaging (MRI), and blood tests to rule out other conditions.
Management and Treatment
Complications
Complications of trigeminal neuralgia may include:
- Quality of life: The chronic nature of trigeminal neuralgia can significantly impact a person's quality of life, causing emotional distress, anxiety, and depression.
- Medication side effects: Long-term use of medications to manage trigeminal neuralgia may lead to side effects such as dizziness, drowsiness, and weight gain.
- Reduced mobility: In some cases, the pain may immobilize the affected individual, making it difficult to perform daily activities or engage in social interactions.
- Depression and anxiety: The constant pain and discomfort associated with trigeminal neuralgia can contribute to mental health issues like depression and anxiety.
- Impaired sleep: Severe pain episodes may disrupt sleep, leading to fatigue, irritability, and decreased overall quality of life. It is essential to seek medical attention and follow a treatment plan to manage trigeminal neuralgia and minimize the risk of complications.
Treatment
Treatments for trigeminal neuralgia may include medications, injections, or surgery. Medications can help relieve pain, while injections can provide temporary relief by reducing the pressure on the affected nerve. Surgery, such as microvascular decompression or nerve decompression, may be considered for more severe cases. It's important to consult with a healthcare professional for a proper diagnosis and personalized treatment plan.
Preparing for medical consultation
To prepare for an appointment for trigeminal neuralgia, you should:
- Note any symptoms you've been experiencing, such as the type, location, and triggers of your facial pain.
- Make a list of your key medical information, including any other conditions you're being treated for and the medications, vitamins, or supplements you're taking.
- Consider bringing a family member or friend for support and to help remember important details.
- Prepare a list of questions in advance to ask your doctor, such as the cause of your pain, recommended diagnostic tests, treatment options, and potential side effects of medications.
- Be prepared for your doctor to conduct a neurological examination and possibly order tests like an MRI to diagnose trigeminal neuralgia and rule out other conditions. Remember to share your symptoms, triggers, and any relevant medical information with your doctor during the appointment to help them make an accurate diagnosis and recommend appropriate treatment.