TRIGEMINAL NEURALGIA

Trigeminal Neuralgia Diagnosis & Treatment at Mir Neurology

What is Trigeminal Neuralgia?

Trigeminal neuralgia (TN), also known as tic douloureux, is a chronic neurological pain disorder that affects the trigeminal nerve, which is responsible for facial sensation. This condition causes severe facial pain, often described as sudden, stabbing, or electric shock–like pain, and is commonly triggered by everyday activities such as speaking, chewing, shaving, or brushing your teeth.

Trigeminal neuralgia is widely regarded as one of the most severe facial pain conditions in clinical medicine. It is a form of cranial nerve disorder that can significantly impact daily functioning and emotional well-being. At Mir Neurology, we specialize in the diagnosis and treatment of trigeminal neuralgia, helping patients achieve long-term pain relief and improved quality of life.

Symptoms of Trigeminal Neuralgia:

The hallmark of trigeminal neuralgia is sudden, severe facial pain, which may last anywhere from a few seconds to a couple of minutes. Symptoms typically occur in episodes, and the pain is often described as one or more of the following:

Sharp, shooting, or stabbing pain: This pain typically occurs on one side of the face and can be triggered by activities like speaking, eating, or brushing your teeth.
Pain that radiates along the jaw, cheek, teeth, gums, or forehead: Depending on which branch of the trigeminal nerve is affected.
Tingling or aching sensations: Between pain episodes, some individuals experience mild discomfort or an ongoing aching sensation.
Pain triggered by touch: The pain may be triggered by simple stimuli such as touching the face, wind blowing, or smiling.

Trigeminal neuralgia usually affects one side of the face, but in rare cases, it can affect both sides.

Types of Trigeminal Neuralgia:

There are two primary types of trigeminal neuralgia

Type 1 (Classic Trigeminal Neuralgia): This form is characterized by severe, shock-like pain that comes and goes, typically triggered by touch or movement.
Type 2 (Atypical Trigeminal Neuralgia): This type involves a dull, constant ache or burning sensation that may be less intense but more persistent than Type 1.

Causes of Trigeminal Neuralgia

The most common cause of trigeminal neuralgia is vascular compression, where an artery or vein presses on the trigeminal nerve, leading to abnormal nerve signaling. Other potential causes include:

Vascular Compression-A blood vessel pressing against the trigeminal nerve can cause the nerve to malfunction, leading to the sudden pain characteristic of trigeminal neuralgia.
Multiple Sclerosis (MS)- In MS, the protective myelin sheath around the trigeminal nerve can be damaged, disrupting nerve signaling and leading to trigeminal neuralgia.
Nerve Injury-Trauma or injury to the face or head can damage the trigeminal nerve, potentially leading to the development of trigeminal neuralgia.
Aging -Trigeminal neuralgia is more common in older adults due to the natural aging process, which may lead to blood vessel changes or nerve degeneration.

Diagnosis of Trigeminal Neuralgia

At Mir Neurology, we use a comprehensive neurological approach to accurately diagnose trigeminal neuralgia and rule out other causes of chronic facial pain.

1. Medical History and Symptom Review

A detailed evaluation of pain location, duration, triggers, and frequency helps distinguish trigeminal neuralgia from other headache or facial pain disorders.

2. Physical and Neurological Exam

A neurological examination assesses facial sensation, reflexes, and muscle strength to evaluate nerve function.

3. Magnetic Resonance Imaging (MRI)

An MRI is often recommended to rule out other causes of facial pain, such as tumors or multiple sclerosis. It can also detect vascular compression affecting the trigeminal nerve. High-resolution brain MRI is used to identify vascular compression, tumors, or neurological conditions such as multiple sclerosis.

4. Electrodiagnostic Testing

In select cases, specialized nerve tests may be used to assess nerve integrity, though imaging remains the primary diagnostic tool.

Treatment for Trigeminal Neuralgia

Treatment for trigeminal neuralgia is focused on managing pain and addressing the underlying cause. Mir Neurology offers a range of treatment options, including both medical management and surgical interventions, tailored to your specific needs.

1. Medications

The most common treatment for trigeminal neuralgia is the use of anticonvulsant medications, such as carbamazepine, which help to regulate nerve signaling and reduce pain. Other medications, such as baclofen or gabapentin, may also be prescribed to manage symptoms.

2. Botulinum Toxin Injections

Botox injections are sometimes used as an alternative or complementary treatment for trigeminal neuralgia. Botox helps to reduce nerve activity and muscle spasms, potentially reducing the frequency and severity of pain.

3. Surgery

If medications are not effective or cause significant side effects, surgical options may be considered:

Microvascular Decompression (MVD): This procedure involves surgically removing or repositioning blood vessels that are pressing on the trigeminal nerve.
Stereotactic Radiosurgery: A non-invasive procedure that uses focused radiation to treat the trigeminal nerve, reducing pain by damaging the nerve.
Rhizotomy : A procedure where a small portion of the trigeminal nerve is cut or damaged to interrupt pain signals.

4. Alternative Therapies

Adjunctive therapies such as acupuncture, biofeedback, and physical therapy may help reduce pain triggers and improve facial muscle control.

Living with Trigeminal Neuralgia

Living with trigeminal neuralgia can be challenging due to sudden, severe facial nerve pain and neuropathic facial pain that may disrupt daily life. Activities like eating, talking, or brushing teeth can trigger episodes, causing chronic facial pain and emotional stress. Trigeminal nerve disorder may lead to anxiety, sleep problems, and difficulty concentrating.

Effective management combines medications, minimally invasive procedures, and pain management strategies to reduce attacks. Stress reduction, trigger awareness, and lifestyle modifications can help improve overall quality of life. Contact Mir Neurology today to receive expert care for trigeminal neuralgia and regain control over your daily life.

FAQs

What triggers trigeminal neuralgia pain?

Pain is often triggered by facial movements, chewing, speaking, brushing teeth, or exposure to cold air.

Is trigeminal neuralgia curable?

There is no permanent cure for most cases, but medications, minimally invasive procedures, and surgery can significantly reduce symptoms.

How is trigeminal neuralgia diagnosed?

Diagnosis involves neurological exams, medical history review, and MRI imaging to identify nerve compression or other causes.

Can lifestyle changes help manage TN?

Yes, avoiding triggers, stress reduction, and maintaining regular follow-ups can improve daily function and reduce flare-ups.

When should I see a neurologist?

Seek care promptly if you experience sudden, severe facial pain or if over-the-counter treatments are ineffective. Early diagnosis improves treatment outcomes.

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Main Office - Cumberland, United States

Our main office is located in Cumberland, United States. Our doctors have office hours at additional locations in the Hagerstown area to better serve our patients.

924 Seton Dr Suite C, Cumberland, MD 21502, United States.

(301) -797-7600