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Trigeminal Neuralgia
What should I do if trigeminal neuralgia recurs?
After the recurrence of trigeminal neuralgia, oral medication can be considered as the initial treatment. If the effect of the medication is not clear, or the side effects are intolerable, then balloon compression or radiofrequency treatment can be considered. These two methods can be used repeatedly, but they also have a certain recurrence rate. If neither medication nor radiofrequency treatment achieves satisfactory results, then surgical treatment can be considered. Microvascular decompression surgery of the trigeminal nerve can be performed under a microscope, where the trigeminal nerve and the blood vessel compressing it are separated, which can fundamentally resolve trigeminal neuralgia. (Specific medications should be used under the guidance of a physician.)
Does trigeminal neuralgia require craniotomy?
If the severity of trigeminal neuralgia is mild, oral medication can be chosen as the first treatment option. If the effects of the medication are not significant, radiofrequency treatment for the trigeminal nerve or balloon compression therapy can be considered, although these two methods do have a certain recurrence rate. If the effects of medications and treatments like radiofrequency are not significant, microvascular decompression surgery for the trigeminal nerve can be considered. This surgery requires general anesthesia and craniotomy, and under a microscope, the trigeminal nerve and the blood vessels compressing it are separated using a special material, which can relieve the pain of trigeminal neuralgia.
Trigeminal neuralgia prodrome
Trigeminal neuralgia does not have very obvious precursors. This is because trigeminal neuralgia often occurs suddenly, especially with the concept of trigger points. That is to say, once the trigger point is activated, it immediately induces pain without any warning signs. Trigger points vary from person to person, usually located primarily on the cheek. Patients who frequently suffer from trigeminal neuralgia often know these areas. Typically, the pain occurs during activities like brushing teeth with cold water or chewing hard foods such as peanuts or walnuts, triggering severe pain instantly. Thus, in the case of trigeminal neuralgia, there are no precursors, only immediate triggers and immediate pain.
Does trigeminal neuralgia cause dizziness?
For patients with trigeminal neuralgia, they generally do not experience dizziness. Trigeminal neuralgia is mostly due to the presence of a significant culpable vessel around the trigeminal nerve, which continuously compresses the nerve, leading to abnormal discharges of the trigeminal nerve. This is manifested as severe headache pain in the area distributed by the roots of the trigeminal nerve, most often characterized by sharp, stabbing pain, resembling a knife cut or tearing, which is often unbearable for patients. As the condition progressively worsens, the frequency and occurrences of trigeminal neuralgia attacks also gradually increase, often causing extreme pain for the patients.
Trigeminal neuralgia should register for which department?
The department for registering trigeminal neuralgia depends on the distribution of departments in the local hospital. Most commonly, registration is done in the department of functional neurosurgery. However, different hospitals may have different levels of specialization and may employ varying treatment methods which require different departments. For instance, initially, one can register at the department of neurosurgery for oral medication adjustment, usually with carbamazepine. If there is no significant improvement later on, one may register with the department of pain management or anesthesiology for nerve block treatment. Due to the detailed specialization in some hospitals, it might also be necessary to consult other departments. If there is still no effective outcome, it is necessary to register at the department of neurosurgery for surgical treatment to fundamentally address the disease.
What should I do about trigeminal neuralgia of the teeth?
Trigeminal neuralgia in the teeth is generally caused by lesions in the areas controlled by the trigeminal nerve, leading to pain. This pain has trigger points, which could be a particular patch of skin or triggered during face washing, producing paroxysmal, electric shock-like pain. It is important to differentiate this from tooth-related nerve pain. Sometimes toothache may resemble symptoms of trigeminal neuralgia. If dental treatment does not relieve the pain, it might be trigeminal neuralgia related to the teeth. Trigeminal neuralgia requires medication, and there are many types of treatments available. If medicinal treatment proves ineffective, surgical treatment or acupuncture may be employed. In severe cases, nerve tissue blockage can be performed to temporarily relieve the pain.
Trigeminal neuralgia symptoms display
Trigeminal neuralgia typically manifests as sudden, severe facial pain, most often occurring in areas such as the upper lip, nostril, or corner of the mouth. These areas are prone to forming trigger points, and touching or stimulating these points can provoke an episode of pain. Most often, pain attacks occur when the patient is talking or eating, causing sudden cessation of the activity. The patient may experience unilateral facial muscle spasms, and reactions such as frowning, clenching teeth, opening the mouth wide, covering the eyes, or vigorously rubbing the face with the palm of the hand, leading to rough, thickened skin and eyebrow hair loss.
Can trigeminal neuralgia be cured completely?
Trigeminal neuralgia manifests as stubborn, intractable pain, but that does not mean we are helpless against it. The treatment of trigeminal neuralgia mainly involves the following aspects. Medication can only relieve symptoms and is not a cure. Radiofrequency ablation can destroy the trigeminal ganglion, but there is also a high probability of recurrence. The principle of Gamma Knife is somewhat similar to radiofrequency ablation, and the possibility of recurrence is also relatively high. Currently, the most effective treatment for a complete cure is surgical treatment, with about 80%-90% of patients with trigeminal neuralgia achieving complete eradication through treatments such as microvascular decompression surgery.
Early manifestations of trigeminal neuralgia
For patients with trigeminal neuralgia, the initial symptoms mainly include sudden onset of intense pain that stops abruptly. The nature of the pain is generally sharp, resembling sharp stabbing or knife-like pain. In most cases, trigger points are easily formed on the face, commonly appearing around the bilateral nostrils and corners of the mouth as fixed trigger points. Touching these trigger points can easily trigger an attack of trigeminal neuralgia, which lasts for a relatively short duration, typically from a few seconds to several seconds. In most cases, attacks are more likely to be triggered when the patient is tired, fatigued, or under mental stress.
Is occipital neuralgia the same as trigeminal neuralgia?
Occipital neuralgia and trigeminal neuralgia are different; these are two distinct diseases with different onset times, affected areas, and pain characteristics. Occipital neuralgia generally occurs in the back of the head and is associated with cervical spondylosis, neck muscle tension, spasms, injury, trauma, and inflammation, typically triggering pain in the distribution area of the greater occipital nerve. Trigeminal neuralgia generally affects the distribution area of the trigeminal nerve, causing very intense pain, which may be like lightning or a burning sensation. It is typically triggered by washing the face, brushing teeth, or touching and can start and stop suddenly.