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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Is trigeminal neuralgia dangerous?

Trigeminal neuralgia manifests in the regions of the face covered by the distributions of the trigeminal nerve, featuring recurrent, severe pain. The onset of the disorder is sudden and it resolves quickly as well. The pain is usually described as cutting, electric shock-like, burning, or tearing; it is a stubborn, difficult-to-treat pain, colloquially known as the "king of pain" and "the foremost pain in the world," which reflects the extreme level of pain associated with trigeminal neuralgia. Trigeminal neuralgia is generally not fatal, but it inflicts significant harm on the human body, making sufferers feel as if death would be preferable. It causes substantial psychological and physical obstacles and can even trigger the onset of some cardiovascular and cerebrovascular diseases, potentially leading to sudden death. Thus, trigeminal neuralgia is considered a rather dangerous disease.

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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.

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Is trigeminal neuralgia severe?

Trigeminal neuralgia is often described by people as the "world's first pain," highlighting the severity of this condition. Patients usually experience excruciating pain in the areas of the head and face served by the trigeminal nerve during activities such as washing their face, brushing their teeth, eating, drinking, combing their hair, and even in a state of rest. The pain can feel like cutting, burning, tearing, or electric shocks, making it unbearable and extremely agonizing. Clinically, trigeminal neuralgia is characterized by a sudden onset, long duration of illness, and a very slow, or even impossible, recovery. Therefore, those suffering from trigeminal neuralgia often face tremendous physical and psychological challenges. It is a serious disease.

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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.

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How painful is trigeminal neuralgia?

The trigeminal nerve is located on the human face, and trigeminal neuralgia is a common neurological disorder. The most prominent symptom of this disorder is pain that feels like needle pricks or knife cuts. This pain usually occurs very suddenly and is extremely intense. When the pain occurs, patients cannot perform any movements related to the face, severely affecting their quality of life. Moreover, sometimes even a minor movement can trigger repeated episodes of pain, placing the patient in constant severe discomfort. Therefore, trigeminal neuralgia is also referred to as "the worst pain in the world."