What is Trigeminal Neuralgia (TN)?

Trigeminal neuralgia is a pain disorder which affects the fifth cranial nerve, the trigeminal nerve. This nerve controls the functions like chewing and biting and carries sensations from the face to the brain. Though commonly seen in people who are more than 50 years old, trigeminal neuralgia can occur at any age. Women are more frequently affected than men.

What are the causes of TN?

An enlarged artery or vein, injury, tumor, inflammation of the protective membranous covering of the brain (meninges) or other lesions may compress the trigeminal nerve or irritate the trigeminal nerve roots which damage the protective coating around the nerve (myelin sheath) leading to the symptoms of trigeminal neuralgia.

What are the signs and symptoms of TN?

The patient experiences excruciating, intense, stabbing or shock-like pain over the eyes, lips, nose, forehead, lower jaw and upper jaw. An attack may extend from a few seconds to several minutes and may occur several times a day. There might also be a persistent stabbing or aching pain in the area of the face supplied by the trigeminal nerve. The facial pain may be triggered by brushing, shaving, touching the face, applying make-up, chewing, blowing, kissing, etc. Sometimes, even a light breeze touching the face may induce an attack.

What are the diagnostic tests used to identify TN?

A diagnosis is reached based on the description of the symptoms along with a neurological examination. Other causes of facial pain like cluster headaches, nerve pain after an attack of herpes and disorders of the jaw need to be ruled out before a diagnosis of trigeminal neuralgia is reached. A magnetic resonance imaging (MRI) scan may be done to exclude the possibility of a tumor or multiple sclerosis and to provide an insight into the cause of facial nerve compression.  

What are the Treatment options for TN?

1. Medical Management of Trigeminal Neuralgia​

Several medications have been used to treat the disease. The effect of medications vary from person to person and various combinations may have to be tried before a suitable therapy is determined. Surgery may be warranted in patients who do not respond to medical therapy.

2. Surgical Management of Trigeminal Neuralgia​

Surgery is the most successful and frequently sought after treatment option for this condition. MVD or Microvascular Decompression is a smart, elegant procedure used by neurosurgeons to relieve pain.