Trigeminal neuralgia is a condition that results in chronic pain in the face, particularly in the trigeminal nerve. This condition often occurs in women who are aged over 50, however there are fewer than a million cases per year in India, making this condition a rare one. The pain experienced as a part of this condition can often be triggered by speaking, chewing, or brushing the teeth. There is no cure for this condition and the treatment options mainly focus on making it a more manageable condition to live with.
Trigeminal neuralgia is treated with the help of medications. The medicines that will be prescribed function by blocking the pain receptors so that you don’t feel it. Pain management is a large part of living with this condition and you may be prescribed anti-spasmodic medicines, anticonvulsants, or even botox injections to help you with the pain. However, medication is not the only answer. There are many surgical procedures that can be used to control this condition and make it easier to live with. Some of the surgical options include microvascular decompression and brain stereotactic radio surgery. Since this condition occurs mainly in women over 50, the treatments that are employed take into consideration the patient’s medical history and age. Once the severity of the pain is mapped, the doctor will decide what treatment options will suit you the most.
Trigeminal neuralgia is diagnosed on the basis of the type of pain you are experiencing, the part of the face that hurts, and the triggers that activate the pain. With this condition, the pain is often short and sharp and triggered by any stimulation to the cheeks, such as chewing, speaking, or even brushing your teeth. A neurological examination can help doctors understand what is causing the pain. In some cases, an MRI scan is also recommended to get a clearer picture of the problem. Once trigeminal neuralgia is diagnosed, the treatment can begin.
When it comes to the medicines that can be prescribed for this treatment, they range in type from antispasmodic and anticonvulsants, to botox injections. Anticonvulsants can help control the trigeminal nerve in the face in order to lessen the pain. Antispasmodic medications also work on a similar principal. Botox injections are also known to lessen the pain in the nerve, however further studies may be needed to substantiate this.
Trigeminal neuralgia can also be controlled with the help of surgical options. With microvascular decompression, an incision is made behind the ear on the side of the face where you feel the pain. The doctor removes the arteries and veins that come in contact with the nerve, and then adds a soft cushion between the nerve and other arteries. With brain stereotactic radio surgery, the goal is to destroy the root of this nerve. A controlled shot of radiation is given to the nerve to make it stop functioning. The relief in this form of treatment is gradual, but the treatment itself can be very effective. By destroying the nerve, you eliminate the chances of it transmitting the pain to your brain.
Once trigeminal neuralgia is diagnosed, you can seek out the treatment. It is better to start with the medicinal treatments before going in for surgery. However, if they don’t work, you can certainly explore the surgical options.
Sometimes, pain in the face is caused to due multiple sclerosis. It may imitate the symptoms and signs of trigeminal neuralgia but it is an entirely different condition. If you are suffering from multiple sclerosis, then seeking out treatment for trigeminal neuralgia will not help you with your condition. The doctor must treat the sclerosis first for you to experience any relief from the pain.
As is the case with most treatments, there are certain side effects to be vary of. Anticonvulsants can lead to side effects like dizziness, nausea, drowsiness, and confusion. Certain anticonvulsants have negative effects on people with Asian descent. Antispasmodic agents also have a few side effects such as confusion, drowsiness, and nausea. Multiple botox injections can eventually make it harder to move your face naturally. It can also give you a stiff and shiny appearance. Microvascular decompression has side effects that include stroke, facial numbness, loss of hearing, and facial weakness. Brain stereotactic radio surgery can lead to developing numbness in the face as well. Surgery in general comes with side effects like bruising, swelling, and pain.
With some medications, you have to monitor your diet and control your lifestyle. Since trigeminal neuralgia can mostly be treated through pain management techniques, identifying and controlling your exposure to your triggers can go a long way in helping you. For instance, if your trigger is a cold breeze that brushes against your cheek, you may have to limit your exposure to the same.
It can take up to a month for the treatment to start taking effect.
The surgical treatments range in price from Rs. 50,000 to Rs. 1,50,000, depending on where you are getting the procedures done from.
There is no cure for trigeminal neuralgia, therefore the treatment results cannot be permanent. The treatment focusses on reducing and managing the pain you feel and you can expect the pain to swing from low to high throughout your life. The trick is to identify the treatment options that work best for you and continue to administer them as and when they are needed.
There are a few alternative treatments that are being explored for this condition. One such treatment is injecting glycerol injections at the base of the skull in order to damage the trigeminal nerve in the face. Balloon compression is also a treatment that can be used to damage the nerve sufficiently. Radiofrequency thermal lesioning can also be used for the same purpose. It damages the nerve fibres that are associated with pain.