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Trigeminal neuralgia causes facial pain. Trigeminal facial neuralgia develops in mid to late life. The condition is the most frequently occurring of all the nerve pain disorders. The pain, which comes and goes, feels like bursts of sharp, stabbing, electric-shocks. This pain can last from a few seconds to a few minutes.
People with trigeminal neuralgia become plagued by intermittent severe pain that interferes with common daily activities such as eating and sleep. They live in fear of unpredictable painful attacks, which leads to sleep deprivation and undereating. The condition can lead to irritability, severe anticipatory anxiety and depression, and life-threatening malnutrition. Suicidal depression is not uncommon.
People often call trigeminal neuralgia “tic douloureux” because of a characteristic muscle spasm that accompanies the pain.
The pain comes from one or more branches of the trigeminal nerve - the major carrier of sensory information from the face to the brain.
There are 3 branches of the trigeminal nerve: the ophthalmic, maxillary, and mandibular. The pain of trigeminal neuralgia occurs almost exclusively in the maxillary and mandibular divisions.
You most commonly feel pain in the maxillary nerve, which runs along your cheekbone, most of your nose, upper lip, and upper teeth. Next most commonly affected is the mandibular nerve, affecting your lower cheek, lower lip, and jaw.
In almost all cases (97%), pain will be restricted to one side of your face.
Most of the time, doctors cannot identify any disease of the trigeminal nerve or the central nervous system.
Trigeminal neuralgia most frequently affects women older than 50 years. The disease occurs rarely in those younger than 30 years. Such cases are usually linked to damage from diseases of central nervous system, for example, multiple sclerosis.
Trigeminal Neuralgia Causes
The condition has no clear-cut cause.
Some experts argue that the syndrome is caused by traumatic damage to the nerve as it passes from the openings in the skull to the muscles and tissue of the face. The damage compresses the nerve, causing the nerve cell to shed the protective and conductive coating (demyelination).
Others believe the cause stems from biochemical change in the nerve tissue itself.
A more recent notion is that an abnormal blood vessel compresses the nerve as it exits from the brain itself.
In all cases, though, an excessive burst of nervous activity from a damaged nerve causes the painful attacks.
Trigeminal Neuralgia Symptoms
A defining feature of trigeminal neuralgia is the trigger zone-a small area in the central part of the face, usually on a cheek, nose, or lip, that, when stimulated, triggers a typical burst of pain.
A light touch or vibration is the most effective trigger.
Because of this, many common daily activities trigger the attacks.
Washing your face, brushing your teeth, shaving, or talking
Common sensations such as having wind hit your face
Eating and chewing
Many people avoid food and drink rather than experience the severe pain.
These people risk weight loss and dehydration, a leading cause of hospitalization in this group.
People frequently require hospitalization for rapid pain control when their trigeminal neuralgia becomes unmanageable at home.
Between attacks, most people remain relatively pain-free. A subgroup, however, experience a dull ache between attacks, suggesting physical compression of the affected nerve, either by a blood vessel or some other structure.
When to Seek Medical Care
Contact your doctor when you begin to have these pains.
It is essential you see a doctor familiar with the care of patients with trigeminal neuralgia early on to help prevent the development of more severe complications.
It is especially important to work with your doctor because with appropriate drug therapy trigeminal neuralgia can almost always be controlled.
Seek immediate medical attention or go to a hospital's Emergency Department under the following circumstances:
When your current medication does not control the pain and you need immediate relief
When your pain prevents eating and drinking and places you at risk for malnutrition or dehydration
When you experience profound side effects of your medicine such as severe drowsiness, sedation, nausea, or vomiting
When a doctor advises you to seek evaluation and treatment for any of these problems
Exams and Tests
Your doctor must rule out a variety of other causes of facial pain besides trigeminal neuralgia, including various unusual forms of headache.
Atypical neuralgia
Myofascial pain
Temporomandibular facial pain
Cluster headaches
Local disease in the sinuses, jaw, throat, and bones of your head
Physical examination of the head will help define other possible causes of this painful syndrome. Physical findings in people with trigeminal neuralgia are normal.
A doctor should complete an initial neurological examination to determine the presence of other conditions, such as multiple sclerosis, that are associated with nerve pain syndromes like trigeminal neuralgia.
Doctors reserve more extensive testing, such as a CT scan or MRI of the head, for people in whom they suspect an associated condition, such as skull or brain tumor, infection, or neurological condition.
Trigeminal Neuralgia Treatment
Self-Care at Home
Because the pain stems from nerves deep inside your skull, no home remedy is effective.
Medical Treatment
Trigeminal neuralgia is extremely painful but not life threatening. Thus, a goal of therapy is minimizing dangerous side effects.
Medications used to treat trigeminal neuralgia are those used for many other nerve pain syndromes-drugs originally designed to treat seizures.
These antiseizure agents suppress excessive nerve tissue activity, which is the cause of the painful syndrome. As a result, they are useful in conditions such as trigeminal neuralgia.
Pain specialists use invasive therapy, including nerve blocks, nerve destruction, and nerve decompression techniques, as well as drug therapy to treat trigeminal neuralgia.
In some instances, a single injection, or a series of injections, or perhaps one decompressive procedure, will reduce or eliminate the pain and prevent your need for a long course of drug therapy.
Injection techniques also can relieve unremitting pain instantly and further confirm the diagnosis.
Using real-time x-rays, doctors can target the anatomical origin of the nerve deep in your skull. Then, with a fine needle, they can do one of the following to halt the painful syndrome:
Inject that source with anesthetic and steroid.
Inject that nerve with a drug used to destroy faulty cells.
This procedure can be performed with surprisingly little discomfort.
Medications
Doctors use 3 main drugs to treat trigeminal neuralgia-baclofen (Lioresal), carbamazepine (Tegretol), and phenytoin (Dilantin).
Baclofen is the safest of the 3, though less effective. Many doctors begin therapy with baclofen and monitor its results over a week's time.
For years, carbamazepine had been the mainstay for treating this disorder. In fact, many experts believe that if you get no relief from 2 days of carbamazepine treatment, doctors must reconsider the diagnosis of trigeminal neuralgia.
The side effects of this drug include dizziness, sedation, confusion, and rash.
The doctor likely will complete a series of blood and urine tests before beginning treatment to establish a baseline of laboratory values.
Carbamazepine in unusual instances causes a rare blood disease known as aplastic anemia.
Frequent blood monitoring avoids this problem. You can expect to take consistent doses of this medicine for about 6 months before your doctor reconsiders the dosing schedule.
Surgery
If doctors clearly determine the cause of the disorder to be compression of an artery on the trigeminal nerve deep in your skull, a neurosurgeon can perform a microvascular decompression.
The surgeon moves the compressing artery to a location away from the compressed root of the nerve.
The major disadvantage is that it requires a neurosurgical operation-with all its complications-to get access to the root of the trigeminal nerve.
Next Steps
Outlook
Doctors do not know how to prevent trigeminal neuralgia, to predict who will get it, or determine who will respond to a particular treatment until it is tried.
Clearly, though, the overwhelming majority responds to at least one of the treatments and can obtain excellent benefit from it.
More and more people find substantial relief from invasive treatment, either anesthetic injections or decompressive therapy. It is very rare that someone with trigeminal neuralgia does not obtain long-standing relief.
Health
Facial Neuralgia Health medicine neuralgia Trigeminal neuralgia
The life of people living big city distinguishes a lot from life in a small town: it is very occupied, there is less time to have a rest and even having a selection of many interesting businesses , people can't live as they would like to. Big cities are renowned for its terrible ecological situation which is stired up by a big human's desire to earn more money, regardless of even it has grave sequel or can cause a great ecological disaster. Nowaday there are a lot of international associations and conventions about the environment guard, even so some plants, mills, concerns and other enterprises cant's be stopped at once or rearranged because of its high importance in our life. For example, modern people can't just imagine life without electricity. The analysis of thermic anomalies has shown, that the regions with positive highly and medium contrast by thermic anomalies are connected to industrial objects and intensive thermal leakage from underground of the water carrying systems. As a result, people who live in megapolises are badly affected by harmful exhausting from factories and motor transport and by the growing din level which is as bad for people health as lack of fresh air and clean water.
The environmental researches have found out that 80 percent of diseases have arisen in a result of the terrible ecological situation in Moscow. Enviornment pollution and a great amount of different unnatural chemical elements can be a reason of cancerous growth. The statistic of cancer diseases is untoward during last decade and it shows that men have such a bigger bigger occasion to be damaged by some forms of cancer. This disease has probably the highest mortality. Being an inhabitant of megapolis there's no way to elude stress-pressures and tensions are a common section of daily reality here, and it can ba a matter of some problems as apoplexy, high cholesterol, sleep disturbance, immune system problems and even sexuality can be injured sometimes resulting in sexual dysfunction.
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One of the most momentous parts of the being human is sexuality. Read the rest of this entry »
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Family planning is serious business. If you want to give it a try, there are a couple of points to dive into. These factors are good blood, a solid strategy and doing it the right way.
Successful conception has a lot to do with health. It is vital that both you and your partner give up bad habits, pass some health tests at the hospital and stick to a healthy diet. For awoman, healthy food plays a crucial role in raising her fertility range. Before you even consider an effective conception of a child, you should avoid smoking, alcohol consumption and avoid any hazardous surroundings if you want to succeed.
After you have experienced three or four months of a healthy lifestyle, you are prepared to move to the next step: arranging for the time and the place of baby making. We are not in the mood to discuss the place here. While choosing the time, it is best to wait for exceptionally fertile period for a girl also known as ovulation. There are special tools available that should help to estimate the most likely date on the assessment of menstrual cycle information. If the menstrual cycle is repeats itself at regular intervals, you can easily create a proper ovulation calendar also called Read the rest of this entry »
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