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Triggers, symptoms, and causes of trigeminal neuralgia. 

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Trigeminal Neuralgia

Tic douloureux, the chronic pain condition more commonly known as trigeminal neuralgia (TN), is considered one of the most excruciating neurological phenomena that one can experience. The condition occurs when the fifth cranial nerve, being the trigeminal nerve, is in some way compromised. This nerve originates in portions of the midbrain and medulla and splits into two equal ganglia upon exiting the central nervous system, with each ganglion innervating one half of the face. These ganglia further divide into the opthalamic, maxillary, and mandibular branches, which innervate the upper, middle, and lower portions of the face, respectively. Many cases of Trigeminal Neuralgia can be attributed to damage sustained by the trigeminal nerve’s protective myelin sheath, whether by abrasion from an adjacent blood vessel or tumor at the base of the brain stem, or by the neurologically degradative disease known as multiple sclerosis. Other instances of TN have occurred as the result of facial trauma, such as that which can be inflicted by a stroke or invasive facial surgery. Diagnoses of trigeminal neuralgia are typically based on the self-reported symptoms of the patient, with magnetic resonance imaging (MRI) scans sometimes employed to rule out other potential causes of the patient’s pain like tumors unrelated to the condition.

The symptoms of trigeminal neuralgia are highly variable among those afflicted, as two different types of the condition exist. The much more common Type 1, or TN1, is characterized by the abrupt onset of an intense burning sensation. These flashes of pain typically do not exceed a period of about two minutes, but can persist in an on-and-off fashion for up to two hours in a given episode. On the other hand, the less prevalent trigeminal neuralgia Type 2, or TN2, induces a longer-lasting, constant throbbing pain, though the intensity thereof is not quite as extreme as that found in TN1. An individual may suffer with both forms of this disease, and in severe cases, TN1 and TN2 episodes can occur simultaneously. An incredibly rare form of the condition is bilateral neuralgia, in which both sides of one’s face are affected in some capacity at the same time.

Episodes of trigeminal neuralgia are usually triggered by contact with or vibrations of the facial skin which result from everyday activities like eating and drinking or brushing one’s teeth. Although the condition is not deadly, the ease with which these episodes are triggered keeps many of those afflicted from readily engaging in possibly triggering activities. TN has the potential to become progressive, with bouts of pain intensifying and the painless periods between them growing shorter. Anticonvulsant medicines and surgeries are often viable treatment options for alleviating symptoms, though the effectiveness of medicine in treating progressive cases of TN can decrease over long periods of time.

While trigeminal neuralgia can affect individuals of any age, it most commonly occurs in those over the age of 50. Prevalence of TN is more common in women than in men, and although the reason for this discrepancy is still unknown, further research is being conducted on the role of estrogen in this greater susceptibility. On average, new cases of trigeminal neuralgia in the United States average approximately 12 per 100,000 people every year. Unfortunately, the physical, emotional, and social devastation wrought by trigeminal neuralgia sometimes results in suicide by the afflicted individual, but aggressive treatment paired with complementary approaches like nutritional therapy and exercise can make living with the disease much more manageable.

Due to the lack of knowledge regarding the diagnostics and truly effective cures for trigeminal neuralgia, the prospects of this debilitating disease seem rather bleak. However, when we reflect upon how science and technology in the medical field have progressed so profoundly in recent decades, we must likewise be inspired to look towards the future – one in which healing is no longer out of reach for an unlucky few. It is through the commitment of impassioned hearts and educated minds to relieving the suffering of others that modern medicine is now capable of treating cancer with chemotherapy, mediating diabetes with insulin, and so much more. Hopefully, the cure for trigeminal neuralgia is not far behind. Perhaps the one who makes the dream of health a reality for those suffering from this disease will be you!

References:

Pietrangelo, Ann. “Trigeminal Neuralgia.” Healthline, University of Illinois-Chicago, College of Medicine, www.healthline.com/health/trigeminal-neuralgia.

“The Trigeminal Nerve (CN V).” TeachMeAnatomy, teachmeanatomy.info/head/cranial-nerves/trigeminal-nerve/.

“Trigeminal Neuralgia Fact Sheet.” National Institute of Neurological Disorders and Stroke, U.S. Department of Health and Human Services, www.ninds.nih.gov/disorders/patient-caregiver-education/fact-sheets/trigeminal-neuralgia-fact-sheet#3236_1.

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The three branches of the trigeminal nerve (CN V) are the opthalamic, maxillary, and mandibular, which innervate the upper, middle, and lower portions of the face, respectively.