Trigeminal neuralgia involves the trigeminal nerve. It is a painful chronic condition characterized by severe, recurrent pain in the face, usually just on one side. This pain can come from something as simple as a mild stimulation of the face, such as brushing your teeth.
The trigeminal nerve is the largest of the 12 cranial nerves. It's responsible for transmitting sensory information from your brain to the skin of the face, the sinuses, and the mucous membranes. Along with carrying sensation from your face to your brain, the trigeminal nerve also stimulates jaw muscle movement. There are two separate trigeminal nerves -- one either side of the face -- and trigeminal neuralgia tends only to affect one of them.
In short, trigeminal neuralgia is inflammation of the trigeminal nerve. Some medical professionals refer to the condition as tic douloureux because the intense pain can lead patients to contort their faces. Most of us know this better as a tic. The pain that comes from trigeminal neuralgia can be isolated or reoccur every few hours, minutes, or seconds. In the cases of isolation, an individual can go months or years between attacks. Trigeminal neuralgia can lead to chronic pain that affects daily life.
Trigeminal neuralgia can affect people of any age, though it afflicts those over the age of 60 more commonly. In addition to age, the condition is also more common in people with multiple sclerosis, due to the damage MS causes to the myelin sheath responsible for nerve protection. Other risk factors may include sex, as women are more likely to experience the condition than men.
The primary symptom of trigeminal neuralgia is the sharp, stabbing pain in the face. However, other symptoms can crop up. As with most conditions, the symptoms of trigeminal neuralgia can greatly differ from person-to-person. They may include tingling, numbness, and a dull ache.
The primary symptom of trigeminal neuralgia, which affects 100% of people diagnosed with the condition, is sharp and often intense facial pain. Many factors can trigger the pain, which often begins at the angle of the jaw before spreading. Triggers include smiling, talking, chewing, and sometimes even exposure to elements such as the wind. Most people with the condition describe the stabbing pain like an electric shock, and it more commonly affects the right side of the face. The only benefit of this symptom is that it is quite unique and can result in a quick diagnosis.
In rare instances, people with trigeminal neuralgia experience numbness or a tingling sensation in the hours leading up to an attack. This abnormal sensation again occurs on only one side of the face, in the area of the eye, cheek, or jaw.
There are two types of trigeminal neuralgia: typical, and atypical. Hypersensitivity is a symptom of the latter. Atypical neuralgia is more difficult to diagnose and treat than typical trigeminal neuralgia. People who experience hypersensitivity have specific "trigger zones" where they are far more sensitive. These areas are generally located near the nose, lips, eyes, or ears. Hypersensitivity of the face can cause patients to avoid eating, drinking, or kissing.
Another symptom of atypical trigeminal neuralgia is a dull ache or burning sensation, also occurring in the trigger zones mentioned above. This dull ache is less intense than the electric shock sensation of the typical symptoms, but occasional shocks can happen as well. Again, like the numbness and tingling sensations, the dull ache usually happens in the lead-up to an attack.
Due to its consistency and unrelenting nature, trigeminal neuralgia can cause secondary symptoms and conditions, the most common of which is depression. Even when an individual is free of pain, he or she may live in fear of when it will return. In short, it's easy for the patient to feel like avoiding activities or leaving the house. Unfortunately, some of the physical side effects of depression such as malnourishment and dehydration can make the pains from trigeminal neuralgia worse.
Ear pain caused by trigeminal neuralgia has been described as an ice pick stabbing the ear. This ear pain can occur anywhere along the path of the trigeminal nerve, from the temple to the ear, the neck, and beyond. While ear pain could be trigeminal neuralgia, it might also be geniculate neuralgia, which is caused by a compressed nerve.
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