Trigeminal Neuralgia is a painful condition affecting the nerves in the face. It’s also called tic douloureux. The human body has 12 pairs of cranial nerves that pass through small holes at the base of the skull. These nerves relay information from the brain to various parts of the body. In this post, I’ll uncover what triggers trigeminal neuralgia.
The trigeminal nerve is the fifth pair of cranial nerves that run down each side of the head. It’s responsible for facial sensations, and motor functions, such as biting and chewing. Intense pain can result from disorders in the trigeminal nerve. Sufferers describe the pain as electrifying, sudden and sharp. Bouts of pain often lead to anxiety because the person is always anticipating and dreading the next attack.
The Facial Nerves
As its name connotes, the trigeminal nerve is made up of three branches, also referred to as divisions:
1. The ophthalmic nerve: is purely sensory and involves the eye, upper eyelid and forehead.
2. The maxillary nerve: is also primarily sensory, affecting the lower eyelid, upper lip and gums, cheek, and nostrils.
3. The mandibular nerve: is both sensory and motor, and controls movement in the jaw, lower lip area and gums.
Typically, disorders of the trigeminal nerve affect only one side of the face, however this isn’t always the case. Bilateral trigeminal neuralgia is a condition where pain is felt on both sides of the face. The location of the pain depends on which of the three nerves is affected.
Trigeminal Neuralgia Pain
Pain caused by trigeminal neuralgia is not your garden-variety type of pain. In fact, this type of facial pain can be so severe that it’s actually referred to as The Suicide Disease. Before effective treatment options became available, people with this condition would resort to suicide to escape the unrelenting pain.
The short-circuiting, or firing, of the nerve is what causes the intense pain. Some patients have equated the unbearable pain to that of a screwdriver being rammed into the side of their face. Because the pain is so severe, it must be treated. This isn’t the type of pain that can be put on the back burner and dealt with later.
- Pain comes on suddenly
- Is described as electrifying and shocking
- Pain is described as sharp, stabbing and burning
- Can be unrelenting and severe
- Common pain medications are not sufficient for people suffering from TM
- Usually involves only one side of the face, with pain concentrating in the cheek, jaw, teeth and lips
- First-division pain in the forehead and eye area occurs less often
- Pain may last for only a few seconds but could last for several minutes, an hour, or even be constant
- Can be triggered by simple activities like applying makeup or brushing your teeth. Eating, chewing, laughing, and even, excessive talking are all potential triggers
- Pain may worsen over time, with the attacks happening more frequently
- Remission can occur where no pain is felt for a period of time
What Triggers Trigeminal Neuralgia?
The most common cause for this type of neuralgia is pressure on the trigeminal nerve caused by a neighboring blood vessel. As we age, our arteries elongate, creating possible contact with nerves. This contact can degrade the myelin sheath surrounding the nerve fibers. Myelin sheath is crucial as it insulates nerves.
Without this protective coating, nerve fibers can short-circuit and cause the pain associated with TN. This is why trigeminal neuralgia is most often seen in people over 50. Interestingly, women are affected more than men, with elderly women being at the highest risk. Those suffering from this type of neuralgia may initially believe their pain to be the result of previous dental procedures.
Many people desperate for relief will get root canals and teeth extracted, hoping to get to the underlying cause of their pain. Dental problems should be ruled out as a likely cause. Neuralgia pain can also resemble the discomfort associated with an abscessed tooth. If you’ve ever experienced an abscess, you know how painful it is. This gives you a glimpse into the severity of the pain trigeminal neuralgia can cause.
Myelin Sheath Damage And Viruses
More serious causes of TN could be related to myelin sheath damage incident to multiple sclerosis. A tumor pressing on the nerve is a less-likely cause, but one that should be ruled out, as should any kind of facial trauma resulting from an injury, accident or any surgery involving the mouth or sinuses.
Injury to the trigeminal nerve itself should be investigated, as well as the possibility of stroke. An MRI is a valuable diagnostic tool in these cases. Viruses that lie dormant in the nerve root are also implicated in TN. Viruses can become active when the adrenal glands are stressed.
The take home message here is to address your adrenal health in order to put the virus back into remission. Another condition that is associated with a dormant virus that has become activated is shingles. Click here to read about one of my favorite adrenal support supplements.
[Read More: Retroviruses and Their Correlation to Cancer]
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Trigeminal neuralgia is a condition that can’t be ignored, that’s how debilitating the pain can be. Medical treatments include Tegretol, which can suppress the pain entirely in some people. Like any medication, there are side effects, and higher doses are needed over time to suppress the pain. Lyrica and Dilantin are other prescription options. High doses of Dilantin are used to treat unrelenting acute pain that needs to be addressed immediately.
The downside to prescription meds is they may stop working over time, resulting in the need for higher and higher doses, with increasingly more side effects, including memory impairments, dizziness, and an unsteady gait. At this point other alternatives should be considered.
A micro neuro-surgical procedure called microvascular decompression (MVD) is one such option that has proven helpful in many cases of TN. A small opening in the skull is made to determine which artery is pressing on the trigeminal nerve.
The pressure on the nerve is relieved by moving the blood vessel aside, and placing a pad to ensure that no further compression occurs in the future. The affected nerve can then heal and the myelin sheath regenerate. The majority of patients obtain complete relief after surgery, however pain can return in a small percentage of people.
Gamma Knife Treatment
Gamma knife treatment is a form of focused radiation therapy that uses a laser beam to target and radiate the trigeminal nerve to diminish sensation. Radiating the nerve stimulates a healing process to gradually restore the insulation on the nerve fibers. Pain relief is not immediate and may take a few weeks to notice a difference. Gamma knife treatment is a non-invasive treatment method that can be done on an out-patient basis.
Sadly, the numbness that is created via radiation, while providing welcome relief from the pain, may lead to permanent numbness. Pain may return in up to half of patients opting for this type of treatment, however they may enjoy relief for years before the pain returns. Procedures for trigeminal neuralgia are also available where needles are inserted into the face to heat or compress the nerve using a micro-balloon. While these techniques don’t carry the risk associated with surgery, recurrence of pain can be quite high.
Check out this book: “Acupuncture and Moxibustion for Primary Trigeminal Neuralgia”
Complementary Therapy Options
Complementary treatments like homeopathy, acupuncture, and meditation may prove helpful in conjunction with medical treatments. Trigger-point therapy, also called pressure-point therapy, is also worth trying. Pressure is applied to the non-affected side of the face during this type of therapy. A measure of relief can often be obtained by massaging the nerve branch on the opposite side of the affected area. However, this technique must be done at the first sign of pain or discomfort for it to be effective.
If you are experiencing sudden, intense and debilitating pain on one side of your face, that is concentrated in your cheek or jaw area, schedule an appointment with your doctor to determine if you have trigeminal neuralgia, and to consider your treatment options.
Have you experienced the pain of trigeminal neuralgia? Let me know in the comments:)
(1) NCBI: Trigeminal Neuralgia
(2) NCBI: Trigeminal neuralgia and its management
(3) PubMed: Trigeminal neuralgia – diagnosis and treatment
(4) National Institute of Neurological Disorders and Stroke
(5) News Medical Life Sciences: Trigeminal Neuralgia News And Research
(6) Science Daily: Prospect for more effective treatment of nerve pain
(7) Neurology: Trigeminal neuralgia: New classification and diagnostic grading for practice and research
(8) Nature Reviews Neurology: Trigeminal neuralgia linked to demyelination in multiple sclerosis
(9) SDS Journal: Trigeminal neuralgia: case report and literature review
(10) The Facial Pain Research Foundation: Pain Through Pandemic Living with Trigeminal Neuralgia during COVID-19
Disclaimer: This article is strictly for informational purposes only and is not intended to be medical advice.