Trigeminal Neuralgia Treatment in Mumbai — Pain Clinic of India

Tic douloureux (also known as prosopalgia) is a neuropathic disorder of the trigeminal nerve that causes episodes of intense pain in the eyes, lips, nose, scalp, forehead and jaw. TN usually develops after the age of 50, more commonly in females, although there have been cases with patients being as young as three years of age.

The episodes of pain may occur paroxysmally. To describe the pain sensation, patients may describe a trigger area on the face, so sensitive that touching or even air currents can trigger an episode of pain. It affects lifestyle as it can be triggered by common activities in a patient's daily life, such as eating, talking, shaving and toothbrushing. The attacks are said to feel like stabbing electric shocks, burning, pressing, crushing or shooting pain that becomes intractable. Individual attacks affect one side of the face at a time, last several seconds, hours or longer, and repeat up to hundreds of times throughout the day. The pain also tends to occur in cycles with complete remissions lasting months or even years. 10–12% of cases are bilateral, or occurring on both sides.

This normally indicates problems with both trigeminal nerves, since one serves strictly the left side of the face and the other serves the right side. Pain attacks typically worsen in frequency or severity over time. A lot of patients develop the pain in one branch, then over years the pain will travel through the other nerve branches.

Once the correct diagnosis is made, typical trigeminal neuralgia can be effectively treated. Many people find relief from medication, percutaneous procedures like RF ablation, balloon decompression or surgical options named microvascular decompression (MVD). Atypical trigeminal neuralgia, which involves a more constant and burning pain, is more difficult to treat, both with medications and surgery.

Trigeminal neuralgia is sometimes referred to as the “suicide disease.” It is a rare health condition in which the individual experiences chronic pain in the trigeminal nerves.

The trigeminal nerve is the largest of the cranial nerves which are responsible for causing sensations in your face. It stimulates the movement of the jaw muscles and transmits sensory information to the skin, sinuses and mucous membranes in the face.

What is Trigeminal Neuralgia?

Trigeminal neuralgia is a chronic pain condition caused by inflammation in the trigeminal nerves. It is also known by the name tic douloureux. The intense pain of trigeminal neuralgia can occur as an isolated episode or periodically. In some people, there will be a gap of 2–3 years between the attacks; others experience repeated episodes of pain. It affects mostly women above 50 years.

Causes of Trigeminal Neuralgia

The exact cause of trigeminal neuralgia is yet to be figured out. Mostly, it occurs when pressure is exerted on the trigeminal nerve due to other underlying conditions.

Some of the possible reasons for trigeminal neuralgia are as follows:

• As a result of the aging process.
• Multiple sclerosis, which is a chronic health condition that affects the nervous system.
• Systemic diseases like sarcoidosis or Lyme disease.
• An abnormality related to veins or arteries.
• A tumour.
• A fluid-filled sac or cyst.
• Collagen vascular diseases.

Some of the triggering factors of trigeminal neuralgia pain are:

• While you touch or wash your face.
• Shaving.
• Eating or drinking.
• Smiling, laughing or talking.
• Brushing teeth.
• Facial massage or while putting on makeup.

Symptoms of Trigeminal Neuralgia

The common symptoms of trigeminal neuralgia are:

• Episodes of acute, sharp pain similar to an electric shock on one side of the face.
• Spontaneous pain while eating, drinking, chewing, washing the face, etc.
• Pain in the areas of the trigeminal nerve like cheek, jaw, teeth, gums, forehead, etc.
• Intense pain that lasts for a few seconds to several minutes.

How is Trigeminal Neuralgia Diagnosed?

The condition is diagnosed after analysing the type, location and triggering factors of the pain. A neurological examination followed by an MRI scan is conducted to find the underlying cause of trigeminal neuralgia.

Treatment of Trigeminal Neuralgia

Trigeminal neuralgia treatment often begins with medication. In severe cases, injections and surgery are done to cure the condition. If there is an underlying reason for the pain, the relevant treatment method is recommended to get relief from trigeminal neuralgia.