Trigeminal neuralgia causes sudden and severe pain that occurs paroxysmally on the face due to dysfunction of the trigeminal nerve. This article explains the definition, symptoms, causes, diagnosis, and treatment methods of trigeminal neuralgia based on authoritative medical institution materials, guiding patients on key matters they need to know.
What is Trigeminal Neuralgia
Trigeminal neuralgia is a chronic neurological disorder where electric shock-like severe pain repeatedly occurs mainly on one side of the face in the area of the trigeminal nerve, the 5th cranial nerve. This pain is considered one of the most excruciating pains humans can experience and commonly appears in people over 40 years old. It is more frequent in women, with an incidence reported at about 4 per 100,000 people.
Main Symptoms
Pain Characteristics
- Sudden stabbing or electric shock-like pain lasts from seconds to minutes.
- It mainly occurs in the areas of trigeminal nerve branches such as around the mouth, gums, eyes, and cheeks, and is mostly unilateral on one side of the face.
Trigger Factors
- Attacks are triggered by light stimuli such as washing the face, shaving, chewing, talking, or wind brushing.
- The pain temporarily subsides after an episode but can recur repeatedly.
Sensory loss or weakened chewing may accompany it, but this is rare.
Causes and Types
Most cases of trigeminal neuralgia are idiopathic without a specific cause, but often involve blood vessels compressing the trigeminal nerve. Other causes include tumors, multiple sclerosis, infections, and trauma, classifying them as secondary.
Classical or primary trigeminal neuralgia is the most common type, caused by demyelination due to vascular compression. In contrast, secondary trigeminal neuralgia accompanies other diseases such as tumors or multiple sclerosis. The exact cause may vary by patient, so imaging tests are necessary for confirmation.
Diagnosis Methods
Diagnosis is based on symptoms and medical history, with brain MRI being essential. MRI confirms the relationship between the trigeminal nerve and blood vessels and differentiates tumors or other lesions. Electrophysiological tests may be considered if sensory abnormalities are present. Distinguishing it from other conditions like toothache is important.
Treatment Methods
Drug Therapy
Carbamazepine is mainly used as initial treatment, effective in relieving pain in over 90% of cases. Other anticonvulsants such as oxcarbazepine and gabapentin are used as alternatives or adjuncts. Side effects (dizziness, skin reactions, etc.) may occur, so follow the doctor’s instructions.
Non-Surgical Procedures
Partial nerve destruction is performed through radiofrequency thermocoagulation, glycerol injection, or balloon compression. Gamma Knife is a non-invasive radiation therapy, with effects appearing in 4-6 weeks.
Surgical Treatment
For drug-resistant cases, microvascular decompression surgery serves as root treatment by separating the compressing blood vessel. Certain procedures may be covered by health insurance for the elderly or those with treatment difficulties. Treatment selection varies by patient condition, requiring confirmation of the latest policies.
Common Misconceptions and Precautions
It is often mistaken for toothache leading to dental treatment, but it can be distinguished by neuralgia characteristics. Avoid ignoring drug side effects or self-diagnosis. Delayed treatment can lead to chronicity. Specialist consultation is essential for the elderly or those with comorbidities. Application criteria may change with policy updates, so check the latest information.
Frequently Asked Questions
Is trigeminal neuralgia curable?
Symptom relief is possible with drugs or procedures, but cure depends on the cause. Long-term effects are reported with microvascular decompression surgery. Consult with medical staff as individual differences are significant.
How is trigeminal neuralgia pain different from toothache?
Toothache is continuous and accompanied by swelling, while trigeminal neuralgia is paroxysmal and electric shock-like. Visit a neurologist for accurate diagnosis.
What are the side effects of trigeminal neuralgia medications?
Common ones include dizziness, fatigue, and skin rashes. Report symptoms to your doctor immediately.
When should surgery be considered?
In cases of drug resistance or recurrence. Health insurance may apply for specific cases like those over 65, but criteria need confirmation.
Must-Check Items Before Applying for Trigeminal Neuralgia
Before receiving treatment support or health insurance coverage related to trigeminal neuralgia, directly verify the following on official government or public institution websites.
- Whether your symptoms meet the trigeminal neuralgia diagnosis criteria.
- Current year’s treatment application criteria (e.g., drug resistance, elderly conditions).
- Allowed treatment methods and usage scope (drugs, procedures, surgery).
- Methods to check remaining treatment counts or status.
- Latest policy changes (may vary by year).
This information enables accurate judgment suited to your personal situation.
Next Steps to Know for Trigeminal Neuralgia Management
If trigeminal neuralgia is suspected, visit a neurology specialist immediately for diagnosis. After establishing a treatment plan, it is advisable to reconfirm the latest criteria through official announcements or public institution materials. Reconsult without delay if symptoms change, and practice avoiding daily stimuli. All information is for reference, and may vary with policy updates.