What is Trigeminal Neuralgia?

Trigeminal Neuralgia (TN) is nerve pain in the face. It is an extremely painful condition.
Click link to learn more about TN




The trigeminal nerve is one of the cranial nerves.
It comes from the brain into each side of the face.
Just above the ear, the nerve branches into three :
V1 - The Ophthalmic Nerve (eye and forehead)
V2 - The Maxillary Nerve (cheekbone, nose and top teeth)
V3 - The Mandibular Nerve (bottom teeth, chin and jaw)
The trigeminal nerve supplies sensation to the face. It is also responsible for functions such as biting and chewing. Trigeminal neuralgia can affect one or both sides of the face and one, two or all three branches of the nerve. There are two types of Trigeminal Neuralgia :
  • Classic Trigeminal Neuralgia (also known as TN or Type 1)
  • Atypical Trigeminal Neuralgia (also known as ATN or Type 2)
Some patients have both type 1 and type 2. Trigeminal Neuralgia can affect anyone of any age. There are other forms of facial pain, some very similar to TN and just as painful.
What causes the pain?
Often a blood vessel or artery is pressing on the nerve causing the pain. There could be damage to the insulating layers of the nerve (myelin sheath). It can be caused by trauma or it can be related to another condition such as Multiple Sclerosis. Those are just a few causes. However, very often, doctors cannot find an actual cause for this pain.
What is the pain like?
  • Classic Trigeminal Neuralgia/ TN/Type 1 - Pain can be like an electric shock or like a bolt of lightning. This can happen once, several times or sometimes it can continual for a long time. TN like this can go into remission between bouts of attacks.
  • Atypical Trigeminal Neuralgia/ATN/ Type 2 - Pain can be a constant burning, aching, crushing, tingling type of pain. People who have this type, tend to have pain all the time. They may go through spells when the pain isn't as bad, but they don't normally have remission periods.
Both types of pain can be incredibly painful and very difficult to live with. The pain is frequently unbearable, debilitating and prevents people from doing normal, every day tasks such as cleaning their teeth, washing their face, talking, eating and drinking. Certain things, particularly involving the face, can trigger the pain, or make it worse:
• Eating, drinking • Smiling, talking, laughing, crying • Sneezing, blinking, kissing • Washing face, brushing or washing hair, shaving, cleaning teeth • A simple gentle touch • Bending over, tilting the head, being active • Different sounds and noises • Being outside in a breeze, cold weather, thunderstorms • Stress, tiredness Sometimes the pain response to a trigger is delayed. And sometimes, the pain starts with no apparent trigger. A day with activity is often followed by days (or weeks) of more pain. For illustrations on triggers please click here

What can be done to help?


Trigeminal Neuralgia is normally treated with anticonvulsant and/or antidepressant medications. Some of the common anticonvulsants used are tegretol, gabapentin and lyrica. But there are many more. If one medication doesn't help, another may work better. There is always something else, or another combination to try. Ordinary painkillers like paracetamol or ibuprofen do nothing to reduce the pain. Stronger prescription pain medications don't tend to help most people, but some find they can help or at least take the edge off the pain. Surgery called Microvascular Decompression (MVD) is available. A neurosurgeon will cushion the nerve with a teflon pad, which can help some people with Classic Trigeminal Neuralgia. There are also some other less invasive procedures which may help. For more information on meds, procedures and surgery, please click here. Some alternatives such as acupuncture and relaxation therapies help some people. There are also various coping techniques, especially for those people who are unable to take the meds due to allergies or side effects. We have some help on those here.

Hope

Online support groups let people from all around the world support each other and share information about the condition. It is also worth remembering that many people still live a full life despite coping with the condition. There is no cure, but there is research taking place, so there is hope

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