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.
Rs. 50,000 - Rs 1,50,000
Typical Trigeminal Neuralgia and Atypical Trigeminal Neuralgia.
The typical form or this disorder results in certain episodes of severe, sudden, shock-like pain in one side of the face, which lasts for seconds to few minutes.
Trigeminal Neuralgia may have symptoms which include one or more of patterns like the following:
A person might come across spontaneous attacks of pain or even attacks which might get triggered by certain things like touching the face, chewing, speaking or even while brushing the teeth.
When trigeminal neuralgia occurs, the trigeminal nerve’s function gets disrupted. The problem occurs through a contact between an artery or a vein and the trigeminal nerve at the base of one’s brain. This contact puts pressure on the nerve, thus causing it to malfunction.
Trigeminal Neuralgia can occur due to people getting aged or due to any kind of disorder that causes damage to the myelin sheath that protects certain nerves. A number of triggers can lead to the pain of trigeminal neuralgia, which include:
What Is Radiofrequency Ablation for Trigeminal Neuralgia?
Radiofrequency Ablation or RFA is a technique by way of surgery, which helps to direct high-frequency heat on to the targeted areas of the body, such as tumors and tissues. When a person suffers chronic pain that means the high-frequency heat is getting targeted to the nerves.
A person suffering from trigeminal neuralgia, would have his or her doctor, who is a neurosurgeon, uses radiofrequency ablation to hit the trigeminal nerve, thereby destroying the nerve’s ability to get the pain signals transmitted to one’s brain.
Medication is the first line of treatment for trigeminal neuralgia by a neurosurgeon, to see how the patient reacts. If that person suffers from severe pain in the face and does not show any improvement through medication, then the doctor might recommend him/her to go for radiofrequency ablation surgery.
How Is The Procedure Conducted?
During the radiofrequency ablation for trigeminal neuralgia, people remain awake and asleep at different times. The process includes:
When the patient is asleep under the influence of general anaesthesia, a neurosurgeon would carefully place a needle through the corner of one’s mouth in order to reach the trigeminal nerve, which lies at the base of the skull. Then, once the X-rays confirm the needle is right in place, the neurosurgeon would wake the patient up, stimulate the nerve and ask the patient if he or she could feel the stimulation exactly at the place where the pain is experienced. This particular step confirms that the doctor has hit the right location. Once, the patient gets back to sleep, the doctor uses radiofrequency heat to minimally injure the nerve, sufficiently enough to induce a numb feeling on the face along with tingling, thus take the pain away.
Trigeminal Neuralgia is basically a nervous disorder that can affect any person. The condition is caused mainly due to the trigeminal nerve or the 5th cranial nervebeing pressed against by a blood vessel. Cases have been reported without such specific underlying causes as well. The condition can cause light to severe pain and is treated through a combination of medication and other external stimulations.
Things you need to know about Trigeminal Neuralgia
Nerve pains can become unbearable sometimes and have to be treated immediately. The best way is to first take a combination of drugs to control the pain and then use electric stimulation and other methods of external applications to remove the pain.
Fried Methi (Fenugreek) 100gm
Haldi (Turmeric) 100gm
Ganthoda (Granthik) 10gm
Mix it properly
Dose: one tea Spoon Morning & Evening
Castrol oil – one tea spoon with warm water/ milk /tea at bed time once or twice in weak
Fried Lahsun- with ghee and take one two prices every day morning.
Fried Methi (Fenugreek) 100gm
Gud (Jagarry) 50gm
Mix it properly and take two tea spoons early morning.
Trigeminal neuralgia can be best described as an ongoing condition that affects a group of nerves called the fifth cranial nerve which is responsible for sensation in the face. Individuals suffering from this pain say that the pain feels like that of an electric shock and sometimes it becomes unbearably severe. According to medical experts, the trigeminal neuralgia is the acutest pain that an individual can suffer from where the pain mostly affects the lower portion of the face along with the jaw and may also affect the lips, nose, ears and eyes. Trigeminal neuralgia is thought to affect over 1 million people across the world and 1 person in every 15,000 people suffers from this disease.
Understanding the causes of trigeminal neuralgia
The human face comprises of two trigeminal nerves, one on each side of the face and each splits into 3 branches which aid in transmitting sensations of pain as well as a touch from the teeth, mouth, and face to the brain. Most cases of trigeminal neuralgia are said to be triggered by the blood vessels, which sometimes presses the root of the trigeminal nerve. This is known to make the nerve transmit signals which lead to the feeling of stabbing and throbbing pain in the facial regions.
The exertion of pressure on the nerves is mostly caused by multiple sclerosis and tumor and some other suspected causes of trigeminal neuralgia include, pressing of the blood vessel against the root of the trigeminal nerve, demyelization of the trigeminal nerves during the advanced stages of multiple sclerosis, physical damage to the nerve caused by an injury, a surgical procedure or a severe infection, although rare, pressing of a tumor against the trigeminal nerve may also cause it and family history and genetic conditions are also responsible for causing trigeminal neuralgia
Diagnosing trigeminal neuralgia:
If the primary health care provider feels that the symptoms of facial pain are indicative of trigeminal neuralgia, then the patient’s face is required to be examined and evaluated more carefully to detect the affected parts with precision. Other conditions which may have similar symptoms including tooth problems and sinusitis would be eliminated first. Then an MRI scan would be performed which would help understand whether the trigeminal neuralgia is triggered by some underlying medical issues. But the MRI would not be able to reveal the reasons behind the irritation of the nerve unless tumor or multiple sclerosis is the cause. This is because it is not possible to visualize the blood vessel that stands next to the nerve root.
Getting the right treatment for trigeminal neuralgia:
If you wish to discuss any specific problem, you can consult a pain management specialist.
Trigeminal neuralgia is specified by the condition of a chronic pain that influences the trigeminal nerve. This nerve transfers sensation from one’s face to his/her brain. If a person is suffering from trigeminal neuralgia, then a gentle stimulation of face (sourced from brushing teeth or applying makeup) might generate a fright of agonizing pain. The affected person might experience short and mild attacks initially. However, the trigeminal neuralgia might progress and generate more-frequently and longer attack of severely critical pain. Women get affected by this situation more than men get and it is more prominently occur in individuals older than 50 years.
Trigeminal neuralgia does not mandatorily mean that you need to experience a lifelong pain. Various types of treatment alternatives are available and so doctors can usually handle the particular condition effectively by taking help of injections, medications or surgery. Various types of triggers might cause the pain regarding trigeminal neuralgia, such as eating, drinking, shaving, brushing teeth, touching face, smiling, washing face etc.
The symptoms of trigeminal neuralgia might comprise of one or more patterns and some of these are described below:
How does Radiofrequency Ablation treat Trigeminal Neuralgia?
Trigeminal Neuralgia is a chronic and painful condition that involves the trigeminal nerve. There are two separate trigeminal nerves on both sides of the face, which carry the sensations like pain from the face to the body. Each nerve has three branches- forehand, midface and chin and trigeminal neuralgia can cause intense pain in any of these areas.
The pain can be mild and for a shorter duration or it can happen frequently for longer durations. Some experience the pain in cycles where it can come and go for days or even for weeks. Gradually the intensity of the pain lessens.
Cure by Radio-frequency Ablation
The treatment of trigeminal neuralgia is often a challenging process in clinical practice. When medicines do not prove as effective, surgery is the desired option.
How Effective is Radio-frequency Ablation?
The pain is cured almost in 98% of the patients. 50% of patients report recurrence of pain after about two years. Hence the procedure can be repeated in the same patient if necessary.