The trigeminal nerve, which refers to the 5th cranial nerve among the 12 cranial nerves, gives out three major branches, and refers to the cranial nerve responsible for the sensations of the forehead, cheeks, and lower jaw. In addition to transmitting the sense of touch, temperature, and vibration from the face and head to the brain, some act as motor nerves to control the muscles that chew food. The trigeminal nerve, which plays such an important role, undergoes pathological changes due to various causes, and when symptoms such as paresthesia of the face and weakness of the chewing muscles appear, it is called trigeminal neuropathy. When pain is the main symptom of trigeminal neuropathy, it is called trigeminal neuralgia. Trigeminal neuralgia mainly occurs in people in their 50s and 60s, and it is known that the incidence rate is higher in women than men.
The main cause of trigeminal neuralgia is that the nerve itself is stimulated by blood vessels, causing pain. It is known that it is caused by a severe impact to the base of the skull due to trauma, causing damage to the cranial nerves and related structures. It is also reported that damage to the trigeminal nerve caused by otitis media, brain tumor, cerebral aneurysm, multiple sclerosis, etc., including herpes zoster, has a significant impact on the occurrence. Now, let’s take a closer look at the main symptoms of trigeminal neuralgia, as well as various information on treatment and prevention.
Main symptoms of trigeminal neuralgia
When trigeminal neuralgia occurs, severe pain like being stabbed with a sharp knife or awl, and pain like a strong electric shock like electric shock appear instantaneously and convulsively. And these extreme pains appear over a short period of a few seconds or as long as a few minutes, and have a characteristic that they occur continuously in a repetitive form. It mainly appears on one side of the face, and it occurs on the forehead, cheeks, nose, ears, around the lips, around the chin, and on the gums.
These pains occur suddenly during daily life, such as exposure to cold air, brushing teeth, shaving, or drinking water or food. If the pain is severe, even the slightest movement of the mouth makes it difficult to speak, making it difficult to eat normally. And while these instantaneous pains rarely occur while sleeping, when the symptoms get worse, the pain may continue all night long enough to make it difficult to sleep.
The symptoms of trigeminal neuralgia are similar to those of toothache, so it is often the case that the tooth is treated first or the treatment is delayed and neglected. If treatment is delayed in this way, the intensity of the pain may become more severe to the point that normal daily life cannot be performed, and nutritional deficiencies may occur due to difficulty in speaking or eating. In addition, the intensity of extreme pain can even cause psychological problems, leading to symptoms such as depression and social phobia.
Since there is no special way to prevent trigeminal neuralgia, it is important to proceed with the rapid diagnosis and treatment process without delaying treatment when the various symptoms mentioned above appear. In particular, trigeminal neuralgia is often mistaken for toothache. In toothache, pain occurs continuously throughout the day, whereas in trigeminal neuralgia, severe pain is felt and then stopped for a while and then the pain is repeated again.
Trigeminal neuralgia diagnosis and treatment
1. Accurate diagnosis
The symptoms of trigeminal neuralgia are accurately identified based on the typical clinical picture and the trigger site. If no abnormalities are found to explain the pain, a neurological examination such as an MRI scan may be performed to check in detail whether the trigeminal nerve and surrounding blood vessels are in contact. In addition, tests to identify and find the cause of the disease will be conducted together.
2. Treatment according to the diagnosis result
Trigeminal neuralgia is treated with various medications such as pain relievers, anticonvulsants, and muscle relaxants to relieve nerve pain. In the initial treatment using these drugs, the effect is about 70-80%, making it possible to control pain. However, these medications can cause side effects such as liver damage and anemia, so after proper administration, the process is checked and the exact condition is confirmed through regular blood tests.
And if these medications do not work, or if relapses continue to appear, surgery is the treatment method. Surgical treatment includes microvascular decompression, which aims to move blood vessels that compress the trigeminal nerve, nerve block to relieve pain by injecting drugs or heat into the trigeminal nerve, and gamma knife radiosurgery to irradiate high doses of radiation into the trigeminal nerve. A number of treatment methods will be considered.
