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Trigeminal Neuralgia

Trigeminal Ganglion

The trigeminal nerve is responsible for allowing human beings to feel pain, pressure and a change in temperature in the area around the eyes, gums, jaw and forehead. When this nerve becomes compressed, the result is severe pain.

The Causes of Trigeminal Neuralgia

The most common cause of trigeminal neuralgia is a blood vessel that presses against the trigeminal nerve near the brain stem. Over time, the brain’s blood vessels become altered, and this can cause these vessels to rub against the trigeminal nerve. Every time the patient’s heart beats, blood vessels rub against the nerve root, and this wears away the nerve’s protective covering called the “myelin sheath.”

Multiple sclerosis is known to induce trigeminal neuralgia. This autoimmune disorder causes the myelin sheath around the body’s nerves to deteriorate, and the trigeminal nerve can be one of the nerves involved. Other autoimmune disorders have been associated with trigeminal neuralgia, including lupus and scleroderma. The viral infection known as “shingles” can also damage nervous tissue and is believed to be one of the causes of this disorder.

Sometimes, injury to the location produces this condition. For example, sinus or oral surgery, a blow to the face and stroke are all believed to be instigators of chronic facial pain. In rare cases, the patient has a tumor that is pressing against the nerve and causing the symptoms. Some patients have what is called an “arteriovenous malformation,” and it is a tangle of veins and arteries that can press against the trigeminal nerve.
Trigeminal Nerve
The Treatment for Trigeminal Neuralgia

Drugs that keep the nerve from firing are called “anticonvulsant medications,” and physicians prescribe them for patients who have episodic pain that lasts between two seconds and two minutes. These patients have the extreme form of trigeminal neuralgia. Others have the atypical form of the malady that causes constant pain, and it can be successfully treated with opioids.

Trigeminal neuralgia is a degenerative disorder, so the condition worsens as time goes by. Therefore, in most cases, surgery will be necessary. One surgical intervention is “balloon compression.” With this option, the surgeon injures the insulation of the nerves that allow people to feel light touch upon their faces.

Another option is the glycerol injection. The physician injects glycerol into spinal fluid that is located in the area of the trigeminal nerve. This has the effect of damaging the nerve fibers. Those who choose this option must have the procedure repeated several times because the positive effects tend to wear off in one or two years.

Radiofrequency thermal lesioning is a process when the doctor electrically stimulates the affected area by inserting a needle into the base of the skull. The patient is awake at this point and can feel the tingling sensation that the stimulation causes. After the doctor is able to cause tingling to occur in the area where pain is felt, the patient is given anesthesia. Then, the physician applies heat to the area to damage the nerve fibers.

Facial Pain from Trigeminal Neuralgia
Conclusion

Trigeminal neuralgia is caused when an irritant damages the myelin sheath of the trigeminal nerve. The result is excruciating pain that can recur. The condition can be treated with prescription medications, but most patients need to have surgery at some point in the future. Three of their options are balloon compression, glycerol injection or radiofrequency thermal lesioning.