Description, Causes and Risk Factors:
Alternative Names: tic douloureux, Fothergill disease, epileptiform neuralgia, facial neuralgia, Fothergill neuralgia, trifacial neuralgia.
There are 12 major nerves on each side of your head. These are called cranial nerves. Each one has a different function. The trigeminal nerve is the fifth cranial nerve. It is responsible for sending impulses of touch, pain, pressure, and temperature to your brain, from your face, jaw, gums, forehead, and around your eyes. They also supply the muscles that help you to eat.
TN is a condition that affects one of the large nerves in your head, called the trigeminal nerve. TN is characterized by a sudden, intense, "stabbing" or "shocklike" facial pain typically felt on one side of the jaw or cheek. It is more common in women than in men and usually affects people aged 50 and older. It is a rare disease affecting around 0.7% of the population, especially in the elderly, and about 15,000 people will be diagnosed with the condition each year.
No known cause has been identified. However, areas of brain swelling or abnormal blood vessels (arteriovenous malformations) can cause it.
Demyelination of the nerve. In rare instances, TN is a symptom of MS which destroys the myelin sheaths protecting the nerve fibers. TN is rarely the first symptom of MS and typically it appears in advanced stages of MS.
Pressure from a tumour on the trigeminal nerve.
Pressure damage to the nerve caused by dental or surgical procedures, injury to the face or infections.
Pressure from a blood vessel on the root of the trigeminal nerve.
Common symptoms include:
Pain that almost always occurs only on one side of the face.
Pain is triggered by certain factors such as chewing, brushing your teeth, washing your face, applying make-up, and even by wind blowing on your face.
Affected area is sensitive to touch.
Pressure or touch to the affected area is felt as pain.
Muscle weakness as a result of motor nerve damage.
Movement may be painful.
Sharp, burning or stabbing pain.Pain that feels like an "electrical shock" or "lightning bolt."Pain usually last from a few seconds up to several minutes and then get better.
There is no single test to diagnose TN. Diagnosis is generally based on the patient's medical history and description of symptoms, a physical exam, and a thorough neurological examination by a physician. Your doctor will ask about your symptoms and your overall health. You also may have magnetic resonance imaging (MRI) of your head to check for possible causes of your face pain. The exams and test may help in finding whether the pain is of TN or any other type.
Several treatment options exist for TN including drug therapy, Gamma Knife radiosurgery, rhizolysis and microvascular decompression.
Gamma Knife radiosurgery uses radiation therapy to inactivate part of the trigeminal nerve.
In rhizolysis, part of the trigeminal nerve is temporarily inactivated by using a heated probe or an injection of the chemical glycerol. These procedures typically provide immediate relief but many patients will have symptoms return during the next several years.
Microvascular decompression is a surgical procedure where a surgeon repositions the blood vessel that presses on your trigeminal nerve. This procedure is a surgical intervention and requires a healthy candidate. It may not be recommended for patients who have had little success with less invasive interventions.
Alternative therapies such as chiropractic adjustments, acupuncture, and meditation have reduced painful TN in some patients.
The most useful group of drugs for this condition is anticonvulsants. It has been found that normal pain killers do not help this pain.
All surgical procedures have a certain element of risk and not all procedures have the same complications, some are specific to particular treatments, some are short term others are long term. All procedures may result in recurrence of pain.
Disclaimer:The above information is general information (informational purpose only, sometimes may not be accurate). The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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