Trigeminal Neuralgia: Introduction
The Trigeminal Neuralgia has two words within it.The first one is Trigeminal nerve largest of twelve cranial nerves which has three divisions i.e. ophthalmic, maxillary, and mandibular supplying to the areas of upper eye-lid to the lower chin. All the sensations from face and mouth are covered by the Trigeminal nerve.
The second one is Neuralgia which means pain. TN is a disorder of the Trigeminal nerve which presents as facial pain and headache. The pain characteristically severe, intense, sharp, episodic, periodical, excruciating, stabbing and short lasting.
TN is also known as tic douloureux.
When the patient’s Trigeminal nerve during an acute neuralgia phase was studied under electron microscope, it was revealed that the abnormality existed at the level of the inner nerve fibers called axons which carry nerve sensation, as well as the myelin (the nerve lining covering the nerve fibers). Due to the damage to such delicate parts, the nerve fiber behave like electrical wire with open ends, leading to electric shock like pain induced by touch or jerk.
What causes Trigeminal Neuralgia?
The causes of TN are explained in detail on a separate page. In short, it has been increasingly proved and understood that most cases of TN have demyelination of the sensory nerve fibers of the Trigeminal Nerve, either in the nerve root or (rarely) the brain stem. Demyelination means an erosion of the nerve sheath, which leads to the exposure of the nerve fibers. The exposed nerve fibers often get compressed or irritated by blood vessels (pulsating arteries or veins), which lead to painful episodes of Trigeminal Neuralgia due to misfiring of the nerve..
Tips for Trigeminal Neuralgia Pain Management
Some tips to avoid painful attacks:
1. Avoid exposure to wind and draft of cold air
2. Avoid (mental and physical) stress such as anxiety, lack of sleep, long drives, etc.
3. Avoid low room temperature for throughout the night, it might aggravate pain at night or on waking up
4. Identify some trigger factors such as cold water, gargling, certain facial movements while eating or shaving, etc. and avoid them
5. Avoid missing doses of medicines
6. Avoid eating hard food articles
7. Learn to avoid sudden jerky movements, turning neck while driving, etc.
8. Maintain excellent oral hygiene to avoid dental carries