What Is Trigeminal Neuralgia?


Trigeminal Neuralgia is a pain disorder that affect the trigeminal nerve. This condition is most commonly experienced by women aged 50 years and over than in men of the same age range. The trigeminal nerve is the nerve that delivers sensation from the face to the brain, as well as controlling some of the motor's facial functions, such as chewing and biting. This condition generally affects only one side of the face. In most cases, both sides of the face can be affected, but very rarely and occur not at the same time.


Causes of Trigeminal Neuralgia
Trigeminal neuralgia is caused by disruption of trigeminal nerve function. The pressure of the blood vessels to the trigeminal nerve in the area at the bottom of the brain is the underlying cause of this condition. This pressure causes impaired function in the trigeminal nerve.
Trigeminal neuralgia in some cases can be caused by abnormalities in the brain from injury or injury, the effects of surgical procedures, stroke, tumors that suppress the trigeminal nerve, or trauma experienced by the face. Trigeminal neuralgia is also associated with an abnormality that causes damage to the neuroprotective membrane called myelin, as in multiple sclerosis. In addition, this condition can also arise as the aging process.

Trigeminal neuralgia leads the patient to become more sensitive to small stimuli so as to feel excessive pain. Some of the triggers are touching face, talking, smiling, dressing or wearing makeup, shaving, eating, drinking, brushing, washing your face, even exposed to the wind.

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Trigeminal Neuralgia Symptoms
The pain may feel similar to sting, seizures or cramps, or a continuous burning sensation with lower pain intensity. Patients can feel pain at one point in the face area or as it spreads throughout the face, but pain is rarely felt on both sides of the face. This condition can be easily triggered by other activities, such as brushing and even talking.
Areas that usually feel pain due to this condition are the cheeks, jaws, lips, gums, teeth, jaws, and in rare cases can affect the area of ​​the eyes and forehead. This sort of pain attack can suddenly last in seconds to a few minutes with a painless pause that intersects each episode of attack. Pain attacks accompanied by hot or sore feelings can take place and occur more often and longer. This may take up to several days, weeks, months, or longer. Sometimes people with trigeminal neuralgia do not feel pain for some time, although they still have this condition.

See your doctor immediately if you have symptoms that resemble, or pain in that area that is not lost after the use of painkillers. Although difficult, trying to do daily activities as usual is important because the condition of the body is not maintained or dehydrated can worsen this situation.


Trigeminal Neuralgia Diagnosis
On examination to obtain a diagnosis of trigeminal neuralgia, the doctor will ask questions, such as the time of appearance, location, frequency, trigger, type and severity of symptoms that appear. Doctors will inquire about the history of hereditary diseases and medical actions ever performed on previous facial areas, such as the history of multiple sclerosis, surgery resulting from facial injuries or dental conditions. Furthermore, the doctor may suggest a physical examination or other support test to obtain an accurate diagnosis.

Physical examination, especially neurological tests, will be done by examining the face to find the source of the pain and confirm the diagnosis under these conditions. Through this test also doctors can find out which parts of the trigeminal nerves that are experiencing the disorder. Furthermore, a series of reflex tests may be performed to determine the cause of the impairment of trigeminal nerve function, whether from other stresses or conditions.

To determine the cause of neuronal neuronal nerve disorder, an MRI imaging test and injecting artificial coloring agents into the blood vessels can be recommended by a physician. Thus, the doctor can ascertain whether a tumor or multiple sclerosis causes this condition.


Treatment of Trigeminal Neuralgia
Treatment of trigeminal neuralgia has several treatment options that can be given and combined according to the cause of the condition. The choice of treatment, injections, and surgery can be applied to patients of this condition to deal with the pain they feel. Treatment for cases of trigeminal neuralgia caused by multiple sclerosis can be started by treating the condition of the cause first.
The early handling of trigeminal neuralgia generally begins with the administration of drugs. People with trigeminal neuralgia may not need additional treatment in addition to drugs, or vice versa, medicines given are intended to reduce or block pain signals sent to the brain. Some of these medicines, among others:
  • Anticonvulsants, such as carbamazepine, oxcarbazepine, lamotrigine, phenytoin, clonazepam, and gabapentin. The dose of the drug may be increased or replaced in accordance with the disease response to the drug. Possible side effects include nausea, dizziness, confusion, and fatigue. It is recommended to perform genetic tests before taking these drugs to avoid severe drug reactions.
  • Botox or onabotulinumtoxin injections may be prescribed to reduce the pain that can not be treated with medication. However, this method still needs to be researched before it is used in patients with trigeminal neuralgia.
  • Antispasmodic agent, a class of drugs that can relax the muscles and can be used by carbamazepine. Examples of this class of drugs, namely baclofen. Possible side effects are nausea, fatigue, and daze.
Another method of handling trigeminal neuralgia is a surgical procedure to prevent the occurrence of pressure on the trigeminal nerve by the blood vessels. Surgery is also performed to destroy trigeminal nerves that have malfunction.
As for some types of surgical procedures, among others:
  • Microvascular decompression . Through this procedure, the blood vessels associated with the trigeminal nerve are removed or removed then a cushion is placed in between. In certain cases, doctors may bypass the blood vessels that suppress the trigeminal nerve if necessary. Some of the risks that this procedure has, the pain in some patients, decreased hearing, paralysis, numbness of the face, or stroke.
  • Gamma knife radiosurgery . Through this procedure, the doctor will expose the radiation in a certain dose to the trigeminal nerve roots to damage it and reduce the pain. This procedure can be repeated if the pain strikes back.
There are several other procedures that may be used to treat trigeminal neuralgia, namely by destroying nerve fibers or also called rhizotomy. This procedure can also cause facial paralysis and has several types, namely glycerol injection, balloon compression, and radiofrequency thermal lesioning.

Although generally minimal case studies or concrete evidence to support, some people with trigeminal neuralgia also perform alternative treatments to overcome this condition. Several alternative treatments are commonly used, including acupuncture, chiropractic , vitamin therapy, nutritional therapy, and biofeedback . A doctor's consultation is strongly recommended before you decide to use alternative medicine as an additional option.

Avoiding the triggers of pain during your treatment can help this condition get worse, such as maintaining your body condition by continuing to eat food, but avoid spicy foods or cold drinks that are not too important for your body. Use a straw to drink and choose soft foods to ease the eating process and avoid pain in the mouth.

Support and understanding is very important for people with trigeminal neuralgia. In addition to sharing experiences, support in the form of groups, especially useful in helping patients get the latest care information.

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