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How Trigeminal Neuralgia Can Cause Severe Facial Pain
Many patients will encounter severe facial pain at different points of their lives, with shooting sensations along the nerves indicating that this is at the centre of the problem. If you have been suffering such pains, you may have a case of trigeminal neuralgia. However, this is something that can be effectively treated to bring you lasting relief.
Trigeminal neuralgia is a neuropathic condition caused by the irritation of the trigeminal nerve, which lies close to the brain stem. The normal function of this nerve is to provide feeling to the head and face.
When this functions normally, most forms of touch are not painful. For example, if you run your hand across your cheek, you should normally feel a gentle sensation and no pain. However, this is not the case when trigeminal neuralgia is present, as even a slight touch can be very painful.
Indeed, there can be many triggers. Brushing your teeth, shaving, applying makeup, and even simple activities like eating, drinking or smiling can trigger the problem. This can make normal life difficult and painful.
Other common features of the problem include only one side of the face being affected, although pain can be felt on both sides in a minority of instances.
The condition tends to get worse with age and will generally affect older people more (around 90 per cent of sufferers are over 40), with women suffering more commonly than men (around three cases in women for every two in men).
A less common form is secondary trigeminal neuralgia, affecting around 15 per cent of patients, which can arise from conditions such as tumours or multiple sclerosis. This type is more likely to affect both sides of the face and sufferers are usually younger than those enduring other forms of the condition.
Finally, there is idiopathic trigeminal neuralgia, where even after diagnosis, no clear underlying cause can be identified.
In the case of a tumour, for instance, radiotherapy to shrink it or surgery to remove it (fully or partially) can help reduce or eliminate the pressure on the nerve, preventing it from triggering further attacks.
Stereotactic radiation therapy, including the use of a Gamma Knife, is one of the options for treating the condition directly, along with invasive neurosurgery. This can include inserting a mesh between a blood vessel and the trigeminal nerve to prevent direct pressure, a process known as surgical microvascular decompression.
Alternatively, excising the vessel (if small enough) prevents contact, while the nerve itself may be excised. In the latter case, this may be one of the last resorts, as cutting off the nerve means that while there may be no further pain, it will also reduce general sensation in the affected part of the face.
Surgical options may be used as an alternative to medicinal solutions, such as antiepileptic drugs, which can control seizures and thus limit the pain spasms that can come from paroxysmal trigeminal neuralgia.
These medicinal options are the first response in most cases, except when secondary trigeminal neuralgia is diagnosed. If they are ineffective, neurosurgical or radiotherapy treatments become the next option. In secondary cases, surgery or radiotherapy are the obvious routes to take, especially when a tumour is the underlying cause.
Our experts in the field will be able to examine closely what the underlying causes of your trigeminal neuralgia symptoms are, with scans helping with any further diagnosis, possibly isolating a causal factor not already identified (as may be the case in idiopathic cases). This could help guide the next steps.
Whether it is surgery or stereotactic radiotherapy, our specialists will be able to bring a new approach to your condition. This may result in a long-awaited solution that brings great relief and enables you to undertake normal activities again without experiencing severe pain.
Learn more about our advanced radiotherapy and neurosurgical treatments for trigeminal neuralgia on the Queen Square website.
Trigeminal neuralgia is a neuropathic condition caused by the irritation of the trigeminal nerve, which lies close to the brain stem. The normal function of this nerve is to provide feeling to the head and face.
When this functions normally, most forms of touch are not painful. For example, if you run your hand across your cheek, you should normally feel a gentle sensation and no pain. However, this is not the case when trigeminal neuralgia is present, as even a slight touch can be very painful.
Indeed, there can be many triggers. Brushing your teeth, shaving, applying makeup, and even simple activities like eating, drinking or smiling can trigger the problem. This can make normal life difficult and painful.
Symptoms And Characteristics
The symptoms of severe pain can manifest in two ways. One is paroxysmal trigeminal neuralgia, which can be triggered by simple facial movements as described above and leads to sudden bursts of intense shooting, burning pain. The other is continuous trigeminal neuralgia, where the pain is less severe but tends to be continual.Other common features of the problem include only one side of the face being affected, although pain can be felt on both sides in a minority of instances.
The condition tends to get worse with age and will generally affect older people more (around 90 per cent of sufferers are over 40), with women suffering more commonly than men (around three cases in women for every two in men).
The Three Kinds Of Trigeminal Neuralgia
Underlying causes of the condition vary. The most common is primary trigeminal neuralgia, which is caused by an adjacent blood vessel placing pressure on the nerve and irritating it.A less common form is secondary trigeminal neuralgia, affecting around 15 per cent of patients, which can arise from conditions such as tumours or multiple sclerosis. This type is more likely to affect both sides of the face and sufferers are usually younger than those enduring other forms of the condition.
Finally, there is idiopathic trigeminal neuralgia, where even after diagnosis, no clear underlying cause can be identified.
Treatment Options
These causal factors will define how the condition may be treated, but there are several ways in which surgery or radiotherapy can help to tackle this painful condition.In the case of a tumour, for instance, radiotherapy to shrink it or surgery to remove it (fully or partially) can help reduce or eliminate the pressure on the nerve, preventing it from triggering further attacks.
Stereotactic radiation therapy, including the use of a Gamma Knife, is one of the options for treating the condition directly, along with invasive neurosurgery. This can include inserting a mesh between a blood vessel and the trigeminal nerve to prevent direct pressure, a process known as surgical microvascular decompression.
Alternatively, excising the vessel (if small enough) prevents contact, while the nerve itself may be excised. In the latter case, this may be one of the last resorts, as cutting off the nerve means that while there may be no further pain, it will also reduce general sensation in the affected part of the face.
Surgical options may be used as an alternative to medicinal solutions, such as antiepileptic drugs, which can control seizures and thus limit the pain spasms that can come from paroxysmal trigeminal neuralgia.
These medicinal options are the first response in most cases, except when secondary trigeminal neuralgia is diagnosed. If they are ineffective, neurosurgical or radiotherapy treatments become the next option. In secondary cases, surgery or radiotherapy are the obvious routes to take, especially when a tumour is the underlying cause.
How We Can Help If Initial Treatment Falls Short
If your situation is one in which you have suffered from severe facial pain for some time and all attempts to tackle it to date have not resolved the issue - specifically the use of antiepileptic drugs and muscle relaxants - now may be the time to see what alternatives are available.Our experts in the field will be able to examine closely what the underlying causes of your trigeminal neuralgia symptoms are, with scans helping with any further diagnosis, possibly isolating a causal factor not already identified (as may be the case in idiopathic cases). This could help guide the next steps.
Whether it is surgery or stereotactic radiotherapy, our specialists will be able to bring a new approach to your condition. This may result in a long-awaited solution that brings great relief and enables you to undertake normal activities again without experiencing severe pain.
Learn more about our advanced radiotherapy and neurosurgical treatments for trigeminal neuralgia on the Queen Square website.
