Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain. If you have trigeminal neuralgia, even mild stimulation of your face — such as from brushing your teeth or putting on makeup — may trigger a jolt of excruciating pain.
You may initially experience short, mild attacks. But trigeminal neuralgia can progress and cause longer, more-frequent bouts of searing pain. Trigeminal neuralgia is rare, with around 10 people in 100,000 in the UK developing it each year. It typically affects women more often than men, and it’s more likely to occur in people who are older than 50.
Because of the variety of treatment options available, having trigeminal neuralgia doesn’t necessarily mean you’re doomed to a life of pain. Doctors usually can effectively manage trigeminal neuralgia with medications, injections or surgery.
What are the symptoms of Trigeminal Neuralgia?
Trigeminal neuralgia symptoms may include one or more of the following symptoms:
- Episodes of severe, shooting or jabbing pain that may feel like an electric shock
- Spontaneous attacks of pain or attacks triggered by things such as touching the face, chewing, speaking or brushing teeth
- Bouts of pain lasting from a few seconds to several minutes
- Episodes of several attacks lasting days, weeks, months or longer — some people have periods when they experience no pain
- Constant aching, burning feeling that may occur before it evolves into the spasm-like pain of trigeminal neuralgia
- Pain in areas supplied by the trigeminal nerve, including the cheek, jaw, teeth, gums, lips, or less often the eye and forehead
- Pain affecting one side of the face at a time, though may rarely affect both sides of the face
- Pain focused in one spot or spread in a wider pattern
- Attacks that become more frequent and intense over time
Trigeminal Neuralgia triggers
A variety of triggers may set off the pain of trigeminal neuralgia, including:
- Shaving
- Touching your face
- Eating
- Drinking
- Brushing your teeth
- Talking
- Putting on makeup
- Encountering a breeze
- Smiling
- Washing your face
Causes of Trigeminal Neuralgia
In trigeminal neuralgia the trigeminal nerve’s function is disrupted. Usually, the problem is contact between a normal blood vessel — in this case, an artery or a vein — and the trigeminal nerve at the base of your brain. This contact puts pressure on the nerve and causes it to malfunction.
Trigeminal neuralgia can occur as a result of ageing, or it can be related to multiple sclerosis or a similar disorder that damages the myelin sheath protecting certain nerves. Trigeminal neuralgia can also be caused by a tumour compressing the trigeminal nerve.
Some people may experience trigeminal neuralgia due to a brain lesion or other abnormalities. In other cases, surgical injuries, stroke or facial trauma may be responsible for trigeminal neuralgia.
Treating trigeminal neuralgia
Trigeminal neuralgia is usually a long-term condition, and the periods of remission often get shorter over time. However, most cases can be controlled with treatment to at least some degree.
An anticonvulsant medication called carbamazepine, which is often used to treat epilepsy, is the first treatment usually recommended to treat trigeminal neuralgia.
Carbamazepine needs to be taken several times a day to be effective, with the dose gradually increased over the course of a few days or weeks so high enough levels of the medication can build up in your bloodstream.
Unless your pain starts to diminish or disappears altogether, the medication is usually continued for as long as necessary, sometimes for many years.
If this medication is ineffective, unsuitable or causes too many side effects, you may be referred to a specialist to discuss alternative medications or surgical procedures that may help.
There are a number of minor surgical procedures that can be used to treat trigeminal neuralgia – usually by damaging the nerve to stop it sending pain signals – but these are generally only effective for a few years.
Alternatively, your specialist may recommend having surgery to open up your skull and move away any blood vessels compressing the trigeminal nerve.
How can the247dentist help with Trigeminal Neuralgia?
If you are suffering from pain inside or around your mouth, a visit to the247dentist is advisable to allow the cause of your pain to be diagnosed. The rareness of Trigeminal Neuralgia makes it more likely that any pain within your mouth is caused by a dental issue which can be addressed by the dentist. Should the247dentist diagnose Trigeminal Neuralgia as the cause of the pain, they can make suitable arrangements to have this investigated further and treated.