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. Running 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 gum, cheek, and nostril.
3. The mandibular nerve: is both sensory and motor, and controls movement in the jaw, lower lip area and gum.
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 firing, or short-circuiting, of the nerve is what causes the intense pain. In fact, some patients equate the unbearable pain with that of a screwdriver being rammed into the side of their face. Because the pain is so severe, it must be treated. It’s not something 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 get worse over time with the attacks happening more frequently
- Remission can occur where no pain is felt for a period of time
Common Causes Of 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. This myelin sheath is crucial, in order to insulate the nerve.
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.
Some will even 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 caused by trigeminal neuralgia.
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 would be a good diagnostic tool in these cases. Viruses that lie dormant in the nerve root are also implicated in TN. Viruses become active when the adrenal glands become stressed. Address your adrenal health to put the virus back into remission. Another condition that is associated with a dormant virus that has become active is shingles. Click here to read about one of my favorite adrenal support supplements.
[Read More: Retroviruses and Their Correlation to Cancer]
What Triggers Trigeminal Neuralgia?
This is a condition that cannot be ignored as the pain can be debilitating. 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 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 often returns 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, resulting in diminished sensation. Radiation to the nerve stimulates a healing process, restoring the insulation on the nerve fibers over time. Pain relief is not immediate, and may take a few weeks to notice a difference. This is a non-invasive treatment method that can be done on an out-patient basis.
The numbness created by this procedure, while providing welcome relief from the pain, may lead to permanent numbness. Unfortunately, pain often returns in up to half of patients after a few years. Procedures 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 is 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 worth trying. In this therapy, pressure is applied to the non-affected side of the face. 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.
If you are experiencing sudden, intense and debilitating pain on one side of your face that is concentrated in your cheek or jaw area, visit your doctor to determine if you have trigeminal neuralgia, and to consider 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.