Trigeminal neuralgia overview

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Overview

Historical Perspective

Pathophysiology

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Differentiating Trigeminal Neuralgia from other Diseases

Epidemiology and Demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Trigeminal neuralgia is a neuropathic disorder of the trigeminal nerve that causes episodes of intense pain in the eyes, lips, nose, scalp, forehead, and jaw.[1]

Historical Perspective

Trigeminal neuralgia is considered by many to be among the most painful of conditions and once was labeled the suicide disease because of the significant numbers of people taking their own lives before effective treatments were discovered.

Epidemiology and Demographics

An estimated one in 15,000 people suffers from trigeminal neuralgia, although numbers may be significantly higher due to frequent misdiagnosis. It usually develops after the age of 40, although there have been cases with patients being as young as three years of age.[2]

Diagnosis

Physical Examination

Signs of trigeminal neuralgia can be seen in males who may deliberately miss an area of their face when shaving, in order to avoid triggering an episode. Although trigeminal neuralgia is not fatal, successive recurrences may be incapacitating, and the fear of provoking an attack may make sufferers reluctant to engage in normal activities.

Treatment

Medical Therapy

There is no cure for trigeminal neuralgia, but most people find relief from medication or sometimes from one of the many so-called complementary or alternative therapies. Atypical trigeminal neuralgia, which involves a more constant and burning pain, is more difficult to treat, both with medications and surgery. During a TN attack, some patients may get quick relief by applying an ice pack or a readily available source of cold temperature to the area of pain.

Surgery

There is no cure for trigeminal neuralgia but most people find relief from one of the five surgical options. Surgery may result in varying degrees of numbness to the patient and lead occasionally to "anesthesia dolorosa," which is numbness with intense pain. However, many people do find dramatic relief with minimal side effects from the various surgeries that are now available.[3]

References

  1. Bayer DB, Stenger TG (1979). "Trigeminal neuralgia: an overview". Oral Surg. Oral Med. Oral Pathol. 48 (5): 393–9. PMID 226915.
  2. Bloom, R. "Emily Garland: A young girl's painful problem took more than a year to diagnose" (PDF).
  3. Weigel, G (2004). "Striking Back: The Trigeminal Neuralgia and Face Pain Handbook". Trigeminal Neuralgia Association ISBN 0-9672393-2-X. Unknown parameter |coauthors= ignored (help)

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