FAQs on Trigeminal Neuralgia Treatment in Philadelphia

Trigeminal neuralgia (TN) is a severely painful condition that affects the fifth cranial nerve (trigeminal nerve). This disorder produces painful, shock-like sensations. Both sides of the nerve branch is affected by this.

What is the trigeminal nerve?

The trigeminal nerve is one of the 12 pairs of nerves attached to the brain. It has three sections. One section supplies the forehead and eye area, the second supplies the cheek, and the third one supplies the jaw. With the trigeminal neuralgia, the nerve branch is affected on one side of the face. Both sides of the nerve branch are affected by the symptoms.

What the two type of trigeminal neuralgia?

Trigeminal neuralgia comes in two forms: Type 1 TN and atypical Type 2 TN. This classic form causes extreme pain, and this only lasts for a short time, and this atypical form causes burning, stabbing, and aching pain.

How common is trigeminal neuralgia?

Trigeminal neuralgia occurs in 0.2 per thousand, and it worsens after 60 years. The rate of this is around 5 per 100,000 persons. The ratio of this condition is 3 to 2. This condition usually affects 50 year old people, but it will occur at any age.

What causes trigeminal neuralgia?

Trigeminal neuralgia is caused by blood vessel compression on the trigeminal nerve. This results in damage to protect the nerve. The TN symptoms are caused by multiple sclerosis, compression from a tumor, or an arteriovenous malformation (mass of arteries and veins). When the nerve is damaged, this results in neuropathic facial pain.

What symptoms are associated with trigeminal neuralgia?

The symptoms of trigeminal neuralgia occur from drinking, brushing teeth, eating, applying makeup, and washing the face. The pain of this condition can lead to fear, panic attacks, and feelings of depression and isolation. Painful episodes cause trouble sleeping, pain with chewing, and worsening anxiety.

How does the doctor diagnose trigeminal neuralgia?

There is no blood test that can diagnose trigeminal neuralgia. The diagnosis is made based on symptoms and history. Many disorders mimic TN and cause facial pain.

How is trigeminal neuralgia treated?

The doctor will usually treat TN with a combination of therapies. Options for treatment include:

  • Medications – The first-line treatment for TN is anticonvulsant medications (carbamazepine and oxcarbazepine). Other agents used are muscle relaxants, such as baclofen and Robaxin, or anxiolytics, such as clonazepam. For severe pain, narcotic analgesics will help.

 

  • Trigeminal nerve block – A small needle is inserted into the side of the jaw to instill a long-acting anesthetic or neurolytic agent onto the nerve. This offers long-term pain relief.

 

  • Microvascular decompression – This procedure is used for patients who do not respond to other treatments. The procedure involves decompressing the vessels around the nerve, which is done through a small incision behind the ear. Based on clinical studies, this procedure has a 90% efficacy rate.

 

  • Percutaneous stereotactic rhizotomy – This procedure involves using electrocoagulation heat to destroy a portion of the nerve root. The doctor will insert a special needle with problem through the cheek.

Resources

Manzoni GC & Torelli P (2005). Epidemiology of typical and atypical craniofacial neuralgias. Neurological Science, 26(Suppl 2), 65-67.

Obermann, M. (2010). Treatment options in trigeminal neuralgia. Ther Adv Neurological Disorder, 3(2), 107-115.