Overview of Trigeminal Neuralgia

Trigeminal neuralgia (TN) is also called tic douloureux (Tic).

The International Association for the Study of Pain (IASP) has defined Trigeminal neuralgia(TN) as “sudden, usually unilateral, severe, brief, stabbing, recurrent pains in the distribution of one or more branches of the fifth cranial nerve (Trigeminal nerve) which carries sensation from face to brain.

The pain involves the jaw and lower face; sometimes it affects the area around the nose and upper part of the eye. Strong intense, stabbing, electric shock-like the pain is caused by irritation of the nerve which is known as trigeminal.

Epidemiologic evidence shows the prevalence of TN to be approximately 4–28.9/100,000 persons world­wide. Women are affected 1.7 times more than men. Onset is usually after age 50 years and increases with advancing age.

Hypertension is a risk factor in women, but the evidence is less clear for men.

A history of Trigeminal neuralgia(TN) in a first-degree relative is also a minor risk factor.

Let’s know more about Trigeminal Disease

Sensation to the face and head region is supplied primarily by cranial nerve V (CN V), which is also known as the trigeminal nerve, (trigeminal is Latin for “born three at a time”) by its three large branches.

V1: The ophthalmic nerve; provides sensation to the eye, orbit, forehead, and portions of the nose

V2: The maxillary nerve; provides sensation to the skin covering the side of the nose, the lower eyelid, the cheek, and the upper lip.

V3: The mandibular nerve; provides sensation to the skin of the lower face, lower lip, and anterior part of the external ear, part of the external acoustic meatus and the temporal region, the anterior two-thirds of the tongue, the teeth of the lower jaw. Mandibular nerve [V 3] is the only division of the trigeminal nerve that contains a motor component and innervates the muscles of mastication and is thus responsible for biting and chewing.

Know the Causes of Trigeminal Neuralgia

The most common cause of typical TN is arterial/venous compression of the trigeminal nerve in the posterior fossa resulting in focal demyelination of the nerve root entry zone

The theory of neurovascular compression is based on three concepts:

(1) A normal blood vessel compresses the nerve in its course through the basal cisterns;

(2) The nerve is compressed in the root entry zone, the area of transition from central to peripheral myelin, which is particularly sensitive to pressure.

(3) Compression results in demyelination and ephaptic (i.e., extrasynaptic)

the transmission of impulses from touch fibers to pain fibers, which results in the paroxysms of pain.

Focal demyelination of the nerve root entry zone leading to TN can also occur secondary to lesions such as tumors, cysts, or multiple sclerosis (also called SYMPTOMATIC TN).

Symptoms of Trigeminal Neuralgia

If you may get severe shooting or jabbing pain that may feel like an electric shock.

Sometimes, pain affects one side of the face at a time, pain may rarely affect both sides of the face.

You can get a constant aching, burning feeling that may occur before it evolves into the spasm like pain of trigeminal neuralgia.

You can face shooting or jabbing pain, “burning”, “tingling”, “electric shock-like”, “pressure”, “stabbing”. That makes you feel like an electric shock. Pain or attacks of trigeminal neuralgia can be triggered by certain actions or movements.

Chewing

A cool breeze or air conditioning

Brushing your teeth

A light touch

Shaving or putting on make-up

Swallowing

Talking

Head movements

Vibrations, such as walking or a car journey

You may get pain more frequent and intense over time.

Pain in areas supplied by the trigeminal nerve, including the cheek, jaw, teeth, gums, lips, or less often the eye and forehead.