Trigeminal neuralgia prodrome

Written by Gao Yi Shen
Neurosurgery
Updated on November 14, 2024
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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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Written by Gao Yi Shen
Neurosurgery
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Is trigeminal neuralgia easy to treat?

Whether trigeminal neuralgia is easy to treat must be judged based on the situation at the time. The vast majority of patients with trigeminal nerve pain can find a corresponding cause, such as compression by blood vessels, tumors, or infection factors. For vascular compression, microvascular decompression surgery can be adopted for treatment. For tumor compression, craniotomy and tumor resection can be adopted for treatment. For some infectious factors, treatment such as anti-infection and hormones can be adopted. These are relatively easier to treat, and most can have a very obvious prognosis. However, there are also cases, such as trigeminal neuralgia where no specific cause has been found, called primary trigeminal neuralgia, where active complete treatment is not possible, and only certain methods can be used to alleviate the general symptoms of the patient and reduce their suffering.

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Written by Jiang Fang Shuai
Neurosurgery
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Trigeminal neuralgia pain level

The World Health Organization classifies pain into five levels. Level zero is no pain. Level one is mild pain that does not require medication. Level two is moderate pain that requires medication. Level three is severe pain that necessitates medication. Level four involves severe and intense pain, often accompanied by changes in vital signs such as blood pressure, pulse, and respiration. Trigeminal neuralgia is a type of severe pain that occurs repeatedly in the trigeminal nerve area. It is recognized globally as one of the most painful diseases, often referred to as the "world's greatest pain" and "the cancer that does not kill." Patients often live in a state of feeling better off dead, which indicates the extreme level of pain associated with this disease. The pain level for this condition is classified as level four, the highest level.

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Written by Jiang Fang Shuai
Neurosurgery
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trigeminal neuralgia area

The trigeminal nerve, being the fifth pair of cranial nerves, branches into three divisions after emerging from the skull. The first division is the ophthalmic division, which innervates the upper eyelid and superficial parts of the eye and forehead. The second division is the maxillary division, governing the cheek, upper lip, and gums. The third division is the mandibular division, which affects the lower lip and gums. Trigeminal neuralgia is pain that occurs in the areas innervated by the trigeminal nerve, typically affecting one side and primarily involving the second and third divisions, with the second being the most common and the third next, while the first division is rare. The pain of trigeminal neuralgia can be confined to the area of one division or can occur in two or all three divisions simultaneously.

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Written by Gao Yi Shen
Neurosurgery
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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.

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Written by Chen Yu Fei
Neurosurgery
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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.