Our heads have 12 cranial nerves, each with their own purpose. The 5th cranial nerve is called the Trigeminal nerve and it’s role is to bring sensation to the face. The nerve has 3 branches (hence TRI-geminal). The Ophthalmic branch brings sensation to the forehead, eyebrow, and eye region. The Maxillary branch brings sensation to the cheek and upper jaw region. Finally, the Mandibular branch not only brings sensation from the temple to the jaw, but also plays a role in providing motor functions for mastication (biting, chewing, and swallowing).
The word “neuralgia” originates from Latin and Greek. “Neur”, meaning nerve and “algia” meaning pain. Nerve pain – no better way to explain it! There are two different types of pain when it comes to Trigeminal Neuralgia. Typical pain can be described as sudden, stabbing, and shocking. Atypical pain can be described as a more constant, burning, throbbing sensation. It is possible for a person to have both typical and atypical pain. The pain is usually unilateral, as the set of nerves control one side of the face each. However, in rare instances, it can be bilateral.
Sometimes the exact cause of Trigeminal Neuralgia cannot be identified, but we know it has something to do with damage to the myelin sheath. The myelin sheath is basically a protective covering of the nerve. My favourite metaphor for it compares it to the insulation around an electrical wire. Damage to the myelin sheath can cause the nerve to send mixed messages and to be more sensitive to stimuli. There are multiple ways to damage the myelin sheath and “cause” Trigeminal Neuralgia. The most common cause is a compression by a blood vessel. Other causes include multiple sclerosis, trauma to the face, a tumour, or an arteriovenous malformation. A similar condition to Trigeminal Neuralgia is Post-Herpetic Neuralgia. PHN is caused by the Shingles virus attacking the Trigeminal nerve.
TN can be triggered by the smallest things: talking, smiling, touching, chewing, kissing, brushing your teeth, washing your hair, and wind are just some of the triggers. Basically, any facial stimuli can lead to horrific and debilitating pain. Imagine a draft of air knocking you to your knees. One of the hardest things about this disease is knowing that you can’t control your surroundings. Leaving the house and going into an unpredictable environment causes a lot of anxiety in TN sufferers. On the note of anxiety, TN can often result in mental heath struggles. A quick Google search of TN will often lead to the phrase “the suicide disease”. Although there hasn’t been any reputable studies done on the suicide rates of TN sufferers, I have personally seen the consequent depression take the lives of many.
Although there is no known cure, some treatments are available. Most often, doctors will prescribe Tegretol (Carbamazepine). Tegretol tends to be quite effective in lessening the pain, but a lot of people can’t tolerate the side effects. There are many other anti-convulsant medications that one can try, but they each have their own pitfalls. Surgical procedures are available, but not every TN patient qualifies for surgery. Some procedures include the MVD, Gamma Knife, Balloon Compression, Glycerol Rhizotomy, and Percutaneous Stereotactic Rhizotomy. The MVD (microvascular decompression) remains the most effective procedure, but is the most invasive and not always an option for people with other health problems.
Other Trigeminal Neuralgia Info:
- TN is most common in women.
- TN is most common in people over 50, but in rare instances it can occur in younger adults, children, and even infants.
- TN can relapse and remit. People can go months/years without pain, only for it to come back one day.
- Depending on the cause, TN can be a progressive disease.
- TN is considered a rare disease.
- TN is often misdiagnosed.
- Many people mistake TN for a bad toothache. Many sufferers have actually had multiple teeth removed, only for the pain to still be there afterwards.
- Painkillers and opioids are not usually the most effective medications when it comes to treating TN.
*All information is my own. Please refer to a doctor before making any decisions about your health.
Branch Diagram: drugs.com/cg/trigeminal-neuralgia.html
Cranial Nerve Diagram: https://radiopaedia.org/articles/cranial-nerves
Blood Vessel Compression Picture: https://seattleneurosciences.com/conditions/trigeminal-neuralgia-treatment/