Trigeminal Neuralgia, if simply put in words, is a condition that causes facial pain when pressure gets exerted on the trigeminal nerve. It is a very rare condition, affecting approximately 12 per 1,00,000 people annually.

Neuropathic pain occurs when a nerve responsible for sensations is damaged, as seen in conditions like trigeminal neuralgia. This pain can result from trauma or a nerve lesion.

These pain attacks can last from a few seconds to up to 2 minutes. This pain can occur from time to time. However, they may get stopped for a time period and then return. This facial pain can be mentally and emotionally devastating.

Dr. Vikas Gupta, a well-known Neurosurgeon, states, “Trigeminal neuralgia is one of the most excruciating conditions a person can experience, but with early diagnosis and the right treatment, we can transform pain into hope and improve the quality of life for those affected.”

In this blog, we will cover who is at risk for trigeminal neuralgia, its diagnosis, treatment options, and whether it can be cured or prevented through medications and surgery.

What are the Symptoms of Trigeminal Neuralgia?

There are only a few symptoms which may suggest that you might be suffering from trigeminal neuralgia; these generally include:

• Pain in face
• Stabbing-like feeling on the face
• Throbbing sensation on facial nerves
• Numbness and tingling around the face

These attacks of pain can also occur while performing some daily activities such as brushing your teeth, doing makeup, eating, drinking, talking, or even sneezing or blowing your nose.

One of Dr. Vikas’s patients who was suffering from this condition stated, “Before being diagnosed with this condition, I didn’t know it existed. I struggled with sudden, unbearable facial pain that made even the simplest daily activities feel impossible. Brushing my teeth or even a gentle breeze could trigger sharp, stabbing sensations. After consulting with Dr. Vikas, I finally found a treatment plan that worked for me. Today, my pain is managed, and I’m thankful to him for that.”

What Are the Causes of Trigeminal Neuralgia?

As you already know, it is caused by the pressure on the trigeminal nerve, but neurologists and neurosurgeons have categorised the causes based on several factors:

• Compression of blood vessels: A normal blood vessel can also compress the trigeminal nerve at a sensitive point, which may cause pain.
• Pre-existing conditions: Conditions like multiple sclerosis can also be a cause of the trigeminal nerve.
• Brain tumour: A tumour can suppress the trigeminal nerve.
• Injury: An injury to the brain or trauma can sometimes be a reason for trigeminal nerves.

How is Trigeminal Neuralgia Diagnosed?

Diagnosing trigeminal neuralgia typically involves several steps:

• Medical History: The doctor will take a detailed medical history, focusing on the nature, duration, and triggers of the facial pain. Patients are encouraged to describe the pain’s characteristics, such as sharpness, intensity, and frequency.
• Physical Examination: A thorough neurological examination is conducted to assess sensory and motor functions. The doctor may test for specific triggers that provoke pain.
• Diagnostic Criteria: The diagnosis often follows the International Classification of Headache Disorders (ICHD) criteria for trigeminal neuralgia, which includes recurrent, unilateral facial pain in the distribution of the trigeminal nerve.
• Imaging Studies: In some cases, imaging studies like MRI may be performed to rule out other causes of facial pain, such as tumours, vascular malformations, or multiple sclerosis. This is particularly important if symptoms are atypical or if the patient is younger than 40.
• Additional Tests: If secondary trigeminal neuralgia is suspected, further tests may be done to evaluate for underlying conditions that could contribute to the symptoms, such as blood tests or additional imaging.

What Are the Treatment Options for Trigeminal Neuralgia?

Treatment options for trigeminal neuralgia aim to relieve pain and improve quality of life. They include:

Medications:

• Anticonvulsants: Drugs like carbamazepine and oxcarbazepine are commonly prescribed to manage pain.
• Muscle Relaxants: Medications such as baclofen may be used in combination with anticonvulsants.
• Tricyclic Antidepressants: Amitriptyline or nortriptyline can help alleviate pain in some patients.

Surgery:

• Microvascular Decompression: This procedure involves relocating or removing blood vessels that compress the trigeminal nerve.
• Rhizotomy: A technique that selectively destroys nerve fibres responsible for pain transmission.
• Gamma Knife Radiosurgery: A non-invasive procedure using targeted radiation to disrupt pain signals without incisions.

Some people may also find relief with lifestyle modifications, such as avoiding known triggers and managing stress, which can help reduce the frequency and intensity of pain episodes. Additionally, some patients may find comfort through alternative therapies, including acupuncture, biofeedback, and meditation.

What is the Cost of Trigeminal Neuralgia in India?

The cost of trigeminal neuralgia treatment depends on numerous factors such as the type of treatment opted, hospital stay, doctor’s fees, diagnostic tests, and location.
The average cost of treatment for trigeminal neuralgia in India ranges from INR 100,000 to INR 300,000 (approximately USD 1,200 to USD 3,600). The final amount depends on the type of treatment chosen, such as medications or surgical procedures like microvascular decompression, radiofrequency rhizotomy, or gamma knife radiosurgery, as well as the location and hospital facilities.

Conclusion

While trigeminal neuralgia is a rare condition, its intense facial pain can severely impact a person’s quality of life. Understanding the symptoms, causes, and diagnostic processes is crucial for those affected, as early intervention can lead to better management of the condition. While medication and surgical options are available to alleviate pain, exploring lifestyle modifications and alternative therapies can also contribute to relief.

FAQs

1. What is the immediate relief for trigeminal neuralgia?

Rhizotomy offers the fastest relief from trigeminal neuralgia pain.

2. What is the best home remedy for neuralgia?

Applying a heat pack or cold pack to the area can help.

3. What is the best medicine for trigeminal neuralgia?

The most helpful medicine for trigeminal neuralgia is Carbamazepine (Tegretol).

4. What foods should you avoid with trigeminal neuralgia?

Caffeine, citrus and bananas are known triggers.

5. What is the best exercise for trigeminal neuralgia?

Exercises, such as walking, swimming, or cycling, are great for people with trigeminal neuralgia.

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