Neurology
- Home
- / Trigeminal Neuralgia
Trigeminal Neuralgia
Trigeminal neuralgia (TN), also known as tic douloureux, is a chronic pain condition that affects the trigeminal nerve, which is responsible for carrying sensation from the face to the brain. Here’s an overview:
Symptoms:
- Intense Pain: Sudden, severe, stabbing or electric shock-like pain in the face.
- Location: Typically affects one side of the face, often the lower face and jaw, but can also affect the area around the nose and above the eye.
- Triggers: Pain can be triggered by mild stimulation of the face such as eating, talking, brushing teeth, shaving, or even a breeze.
- Duration: Attacks can last from a few seconds to several minutes and can occur in rapid succession. Periods of remission (pain-free intervals) can occur but often decrease over time.
Causes:
- Nerve Compression: Most commonly caused by a blood vessel pressing on the trigeminal nerve as it exits the brainstem.
- Multiple Sclerosis (MS): Demyelination of the trigeminal nerve can cause TN in patients with MS.
- Tumors: Rarely, tumors compressing the trigeminal nerve can cause TN.
- Injury: Facial or surgical trauma can damage the trigeminal nerve.
Diagnosis:
- Clinical Evaluation: Diagnosis is primarily based on the patient’s description of symptoms and medical history.
- Imaging Tests: MRI scans can identify if a blood vessel is compressing the nerve or if there are other structural causes like a tumor.
Treatment:
Medications:
- Anticonvulsants: Drugs such as carbamazepine and oxcarbazepine are often the first line of treatment.
- Muscle Relaxants: Baclofen can be used alone or in combination with anticonvulsants.
- Tricyclic Antidepressants: Low doses of amitriptyline or nortriptyline may be effective for some patients.
Surgical Options:
- Microvascular Decompression (MVD): Relieves the pressure on the trigeminal nerve by moving or removing the blood vessel causing the compression.
- Gamma Knife Radiosurgery: Focused radiation to damage the trigeminal nerve and reduce pain signals.
- Rhizotomy: Various techniques (balloon compression, glycerol injection, radiofrequency thermal lesioning) to selectively damage the nerve fibers to block pain.
His very soft spoken, he really treats the patients and family well. He understands the problem of patients. Not just treats them but follows up with them. He makes sure he can do his best and provide his best when under his care. He has saved my life. The best doctor I would recommend it any one wants a plastic surgeon
Patricia Fernandes