How is trigeminal neuralgia diagnosed?

Written by Shu Zhi Qiang
Neurosurgery
Updated on September 02, 2024
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Trigeminal neuralgia is divided into primary and secondary types. Primary trigeminal neuralgia refers to cases where no specific cause is apparent. However, with the advancement of modern medicine, doctors have discovered that there is actually a cause for primary trigeminal neuralgia. It is due to the lack of protective myelin sheath over the initial segment of the trigeminal nerve, which gets irritated by the pulsation of nearby small arteries. In such cases, further investigations like brain MRI and cerebral angiography can usually identify the responsible blood vessel. On the other hand, secondary trigeminal neuralgia occurs along with corresponding tumors and inflammation during the progression of the neuralgia, and MRI can assist in diagnosis.

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Written by Chen Yu Fei
Neurosurgery
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Trigeminal neuralgia physiotherapy methods

For patients with trigeminal neuralgia, in addition to pharmacological treatment, some physical therapies can also be combined, such as massage, acupressure, physiotherapy, acupuncture, and electrotherapy. These physical therapies can help reduce the incidence of trigeminal neuralgia and improve symptoms. It is recommended to undergo physical therapy under the guidance of a professional physician, which can play a supporting role. Of course, physical therapy cannot replace surgical treatment. If the goal is complete treatment, it is advised to undergo microvascular decompression surgery, which plays a crucial role in alleviating pain and stabilizing the condition. (Please use medication under the guidance of a professional physician and do not self-medicate.)

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Written by Chen Yu Fei
Neurosurgery
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Causes of Trigeminal Neuralgia

At present, there is no consensus on the specific causes of trigeminal neuralgia. Most scholars believe that the main cause of trigeminal neuralgia is still due to the presence of a local responsible blood vessel around the trigeminal nerve, which compresses the trigeminal nerve, leading to abnormal discharges of the trigeminal nerve. This results in sudden attacks and sudden stops of severe, knife-like or burning pain, also known as trigeminal neuralgia. In terms of treatment, it mainly involves active drug therapy and some physical therapies, such as massage, manipulation, physiotherapy, and acupuncture. Most patients who experience poor results from conservative treatments can opt for microvascular decompression surgery, which often achieves good therapeutic outcomes.

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Written by Guo Zhi Fei
Neurosurgery
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Trigeminal neuralgia is divided into several branches.

Trigeminal neuralgia is anatomically divided into three branches: the first branch is the ophthalmic branch, the second branch is the maxillary branch, and the third branch is the mandibular branch. The scope of pain can be used to roughly determine which branch is affected. Generally, pain located in the forehead area is caused by the first branch, the ophthalmic branch. Pain in the area from the tip of the nose to the lips is caused by the second branch, the maxillary branch. Pain from the lips to the angle of the jaw is caused by the third branch, the mandibular branch. Therefore, we can understand which branch is in pain by the distribution area and scope of the trigeminal neuralgia.

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Written by Gao Yi Shen
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Trigeminal neuralgia symptoms

Regarding the symptoms of trigeminal neuralgia, there is a very typical symptom, which is the issue of trigger points. A trigger point is a specific spot on the face, which varies for each person. Once this spot is touched, it immediately triggers the pain of trigeminal neuralgia. The nature of trigeminal neuralgia pain is often like cutting or stabbing pain, and the duration varies. If the condition is mild, the initial attack may only last a few seconds, but if the condition gradually worsens without significant improvement, the pain can even last for several minutes. This pain significantly impacts patients, sometimes triggering pain during activities such as brushing teeth, rinsing the mouth, or chewing hard food. Early treatment is essential to mitigate this pain.

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Written by Shu Zhi Qiang
Neurosurgery
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How is trigeminal neuralgia diagnosed?

Trigeminal neuralgia is divided into primary and secondary types. Primary trigeminal neuralgia refers to cases where no specific cause is apparent. However, with the advancement of modern medicine, doctors have discovered that there is actually a cause for primary trigeminal neuralgia. It is due to the lack of protective myelin sheath over the initial segment of the trigeminal nerve, which gets irritated by the pulsation of nearby small arteries. In such cases, further investigations like brain MRI and cerebral angiography can usually identify the responsible blood vessel. On the other hand, secondary trigeminal neuralgia occurs along with corresponding tumors and inflammation during the progression of the neuralgia, and MRI can assist in diagnosis.