Trigeminal Neuralgia

Trigeminal neuralgia is pain associated with the trigeminal nerve or its branches. 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 irritated, the result is severe pain.

The Causes of Trigeminal Neuralgia

One of the causes 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 may wear away the nerve’s protective covering called the “myelin sheath.”

Trigeminal Neuralgia

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,” a tangle of veins and arteries that can press against the trigeminal nerve.

Woman with Face Pain from Trigeminal Neuralgia

The Treatment for Trigeminal Neuralgia

NSAIDS, or non-steroidal anti-inflammatory medications are common first line treatment options. Drugs that keep the nerve from firing are called “anticonvulsant medications,” and these may be prescribed as well. These patients have the extreme form of trigeminal neuralgia. Others have the atypical form of the malady that causes constant pain, and it may be successfully treated with opioids.

In some cases, radiofrequency ablation may be recommended. 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.

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 some patients may need to have surgery at some point in the future.