Trigeminal neuralgia (TN) causes sudden, severe pain in the face. It can last from a few seconds to a few minutes. This pain can be on one side or both sides of the face.
Problems with or excessive pressure on the fifth cranial nerve are the root causes of trigeminal neuralgia. This pain occurs only if there is abnormal pressure on the trigeminal nerve by its attachment to the vein or artery in the lower part of the brain. Apart from this, this pain can also be caused by old age, multiple sclerosis, a brain tumor, the pressure of a tumor next to the nerve, or any other problem.
Sudden, sharp pain like an electric shock. Generally, women are more prone to this disease than men. The pain may worsen when shaving or brushing your teeth. The pain usually lasts a few seconds to less than two minutes. Recurrent pain. Pain occurs in areas where the trigeminal nerve supplies sensation, such as the cheeks, chin, gums, teeth, lips, and occasionally the eyes and forehead.
Doctors usually look for answers to three questions when making a diagnosis. One: What is the type of pain?; two: What is the origin of pain?; and three: What makes the pain worse? Along with some neurological tests, the disease can be diagnosed. Sometimes an MRI, EMG, NCS, etc. may be needed to determine the cause of the disease.
This disease should be treated under the supervision of a neurologist or neurosurgeon. Treatment includes—
Pain relievers acetaminophen, NSAIDs, anticonvulsants carbamazepine, oxcarbazepine, gabapentin, and muscle relaxant baclofen.
Physical therapy (electrical stimulation, ice massage, hot packs, biofeedback); speech therapy (for those who have trouble speaking or swallowing); cognitive behavioral therapy; Adaptive equipment: telephone headsets; Exercise—low-intensity aerobic exercise; relaxation techniques—meditation, etc.
Trigeminal nerve block, local anesthetic nerve block, neurolytic block with alcohol or glycerol, acupuncture
Neurosurgery is usually only needed if other treatments don’t work. In this case, a neurosurgeon performs this surgery using microvascular decompression and gamma knife radiosurgery.
Professor Dr. Haradhan Debnath,
Department of Neurosurgery,
Bangabandhu Sheikh Mujib Medical University