Trigeminal Neuralgia: Recognizing the Symptoms & Seeking Help
Trigeminal Neuralgia is a rare disorder many patients have never heard of until being diagnosed with it themselves. It can be a tough illness both to accurately diagnose and adequately treat. If you believe you’re battling trigeminal neuralgia or that you may need to seek the help of an advanced medical professional for poorly treated trigeminal neuralgia, the following information may help.
Symptoms of Trigeminal Neuralgia
A lightning bolt of pain shears through the side of your face. What could it be? A toothache radiating upward? A migraine sending shoots of pain down? Or perhaps something else entirely?
Pre-trigeminal neuralgia patients experience the onset of this order in different ways. Some patients experience the more gradual onset of pain, growing from merely annoyingly painful to debilitating over hours or even days. Others begin to experience facial pain in conjunction with the pain caused by migraine headaches. And patients can even experience the start of trigeminal neuralgia in the midst of seconds – an immense flash of pain, coming seemingly from nowhere, that engulfs their face.
Check your own experience against these symptoms:
- Severe flashes of pain covering the cheek area between your forehead and chin.
- Pain typically reserved only to one side of the face.
- Pain radiating up from the area of your teeth that are is associated with any dental issues.
- Each jab of pain lasting between a few seconds and a few minutes, then repeating in episodes over time.
- Pain that initially impacts only a portion of the face and then spreads to a larger space.
- Seemingly unrelated stimuli which cause flashes of pain, such as blowing wind or AC, very hot or cold food, metal silverware touching teeth, or rapid facial or head movements.
Trigeminal neuralgia can come and go, with patients experiencing long periods of remission between episodes. Additionally, patients may have trigeminal neuralgia symptoms well managed medically for a period of time before waves of pain overwhelm the medicine used to prevent or treat it.
Treating Trigeminal Neuralgia
Trigeminal neuralgia should always first be treated medically before any type of surgical interaction is considered. Trigeminal neuralgia should also be treated by a neurologist who is familiar with the disorder.
The first line of treatment is typical anti-epileptic/anti-seizure medications such as Tegretol or Trileptal. It can take a long amount of time to determine which medication a patient will respond better to, and at what dosage. In addition, these medications can cause undesirable side effects, which must be balanced against the positives which some trigeminal neuralgia patients can experience through their use.
When to See a Surgeon
You’ll know that it’s time to seek out a neurosurgeon when one of two things happen:
- Medications no longer provide adequate treatment for the pain caused by your trigeminal neuralgia.
- Negative medication side effects outweigh the benefits experienced by using those drugs.
Your neurologist will likely give you a recommendation to first seek the help of a facial pain specialist, or advise you to go directly to a neurosurgeon. A neurosurgeon is a highly trained medical professional who specializes specifically in disorders involving the nervous system. Beyond basic medical school education, they have completed at least five years of a residency, internship and/or a fellowship. You’ll work with a neurosurgeon who is specifically knowledgeable of trigeminal neuralgia and the advanced surgical techniques that can treat it.
Surgical Treatments for Trigeminal Neuralgia
Once you begin working with a neurosurgeon, you’ll learn about four different techniques for treating trigeminal neuralgia surgically. They are:
- Microvascular Decompression – This is the preferred method of treating trigeminal neuralgia for otherwise healthy patients whose radiological imaging shows nerve compression. It involves resolving the impingement on the trigeminal nerve by placing a surgical sponge between the offending blood vessel and the nerve line.
- Gamma Knife Radiosurgery – This intricate technique involves holding the patient’s head in a head frame, then focusing multiple beams of radiation on the trigeminal nerve in order to interrupt the flow of pain.
- Percutaneous Rhizotomy – Using this treatment, a specialized needle is inserted near the trigeminal nerve and directed to a location where the nerve nears the brain stem. Then, heat is applied through the needle to create a disruption along the nerve.
- Pain Stimulator Placement – A stimulator is implanted that sends a signal along the nerve that confuses signals the nerve has been sending. This confusion interrupts the pattern of pain along the nerve and can be a last line of consideration for patients who have not experienced relief through other methods.
Treating Your Trigeminal Neuralgia
No one should have to live with the pain of trigeminal neuralgia. If you aren’t already, begin working with a qualified neurologist or facial pain specialist. You may be able to experience complete or near-complete relief through medicinal management of your disease. If this fails, don’t hesitate to retake control of your life and seek out a neurosurgeon today.
