What should I do if trigeminal neuralgia recurs?

Written by Li Pei
Neurosurgery
Updated on December 11, 2024
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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.)

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Is cold compress effective for trigeminal neuralgia?

Trigeminal neuralgia is a type of intense recurring pain in the facial areas distributed by the trigeminal nerve. When an attack occurs, the pain is unbearable for the patient. Clinically, besides immediately taking medication or opting for surgical treatments after stabilization, applying a cold compress can also alleviate symptoms. Placing a cold towel on the painful facial areas can relieve spasms and pain, improve local swelling, raise the pain threshold, and subsequently reduce the sensation of pain.

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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.

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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.

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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.

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Radical treatment method for trigeminal neuralgia

The fundamental cause of trigeminal neuralgia lies in the compression of the trigeminal nerve root by aberrant blood vessels around the area where it exits the brain stem. This compression leads to demyelination of the trigeminal nerve and causes a short circuit in the trigeminal nerve conduction pathway, resulting in trigeminal neuralgia. Currently, the only definitive cure for trigeminal neuralgia is microvascular decompression surgery. This surgery addresses the cause of trigeminal neuralgia by opening the skull, locating the trigeminal nerve and the compressing vessel, and placing a cushion between the nerve and the vessel to achieve a cure. This type of surgery is characterized by minimal trauma, preservation of nerve function, rapid recovery, and low complication rates, making it the best treatment for trigeminal neuralgia that can achieve a definitive cure.