Trigeminal Neuralgias

What are Trigeminal Neuralgias?

Trigeminal Neuralgias (TN) are a chronic pain condition that affects the trigeminal nerve, which is responsible for transmitting sensations from the face to the brain. It is characterised by sudden, severe, and recurrent episodes of facial pain that can be triggered by simple activities such as eating, speaking, or even touching the face. While the condition is not life-threatening, its intensity can significantly impact a person's quality of life.

Types of Trigeminal Neuralgias

Trigeminal Neuralgia is classified into two main types:

• Type 1 (TN1): Also known as classical trigeminal neuralgia, this type is characterised by sudden, shock-like pain that comes in episodes lasting from a few seconds to minutes. The pain is often unpredictable and can be triggered by light stimulation.

• Type 2 (TN2): Referred to as atypical trigeminal neuralgia, this type presents as constant, dull aching pain that is less severe but more persistent than TN1.

The distinction between the two types helps guide treatment options and management strategies.

Symptoms of Trigeminal Neuralgia

The symptoms of trigeminal neuralgia typically affect one side of the face and include:

• Sudden, intense, electric shock-like pain in the jaw, cheek, or lower face

• Pain episodes triggered by routine actions, such as brushing teeth or talking

• A burning or aching sensation between attacks

• Progressive worsening of the pain over time

Diagnosis and Treatment Options

Diagnosis: Trigeminal Neuralgia is diagnosed through a combination of patient history, clinical examination, and imaging studies:

• MRI Scans: Used to rule out underlying conditions, such as multiple sclerosis or tumours, which may compress the trigeminal nerve.

• Neurological Exams: Assess reflexes and facial sensation to identify potential nerve damage.

Treatment: Management of trigeminal neuralgia involves alleviating pain and addressing its underlying causes. Treatment options include:

1. Medication:

   • Anticonvulsants: Drugs such as carbamazepine are commonly used to stabilise nerve activity and reduce pain.

   • Muscle Relaxants: Baclofen may be prescribed if anticonvulsants alone are insufficient.

2. Surgery:

   • Microvascular Decompression (MVD): A surgical procedure to relieve pressure on the trigeminal nerve caused by blood vessels.

   • Rhizotomy: A minimally invasive option to intentionally damage the nerve fibres, reducing pain signals.

3. Non-Surgical Interventions:

   • Stereotactic Radiosurgery (SRS): A non-invasive method that delivers focused radiation to the trigeminal nerve, reducing its sensitivity.

   • Nerve Blocks: Temporary relief through local anaesthetics or steroids injected near the nerve.

4. Lifestyle and Supportive Measures:

   • Stress management techniques and avoiding known triggers can help minimise pain episodes.

Conclusion

Trigeminal Neuralgia is a debilitating condition that requires a tailored approach for effective management. Early diagnosis and treatment can make a significant difference in reducing pain and restoring quality of life. If you or someone you know is experiencing symptoms of trigeminal neuralgia, consult the specialists at Singapore Brain Spine Nerves Center for compassionate and comprehensive care. Let us guide you on your journey to pain relief and improved well-being.