Treatment for Patients with Trigeminal Neuralgia

Trigeminal Neuralgia is a nerve disorder that differentiates itself from other types of facial pain because it produces sharp, severe pain in different areas of the face, including the upper ear or between the eyes, cheek and jaw.

Neuropathic pain (caused by the trigeminal nerve) is considered to be one of the most painful types of pain. Although it does not pose a danger to the patient, the intensity of the pain can diminish the patient’s quality of life and generate physical disability. For this reason, it is of utmost importance that the symptoms and causes are indentified so that the patient can receive proper treatment. 

The most common symptoms of trigeminal neuralgia are the following:

• The presence of sudden, very intense pain on only one side of the face.  It can be provoked by stimuli (such as exposure to extreme heat or cold, for example) or activities (such as chewing, drinking, eating, laughing, speaking, shaving, among others).
• Intense pain similar to an electric shock that causes heat in the area.
• Constant attacks of pain that last several seconds or minutes.
• Numbness.
• A slight tingling sensation. 

It is important to note that the loss of sensitivity or movement in the affected area is not usually a common symptom of trigeminal neuralgia. If this symptom is present, however, consult your dentist or a specialist in neuralgia immediately. 

Trigeminal neuralgia occurs as a result of the dysfunctionality of the largest sensory nerve in the face, known as the trigeminal nerve (also known as the fifth cranial nerve), which is located on the sides of the face. 

The trigeminal nerve is comprised of three (3) nerve roots (opthalmic, maxillary and mandibular) and is responsible for the sensory and motor functions of this region. 

Once the trigeminal nerve becomes inflammed, trigeminal neuralgia occurs. This is also known as TN or “tic douloureux.” The pain has been described as a sudden electric discharge that can be stabbing or sharp. It appears suddenly and is caused by the superior cerebellar artery located in the root of the trigeminal nerve becoming compressed. 

Risk factors

In order to prevent neuralgia of the trigeminal nerve, it is crucial to understand the risk factors related to this condition, especially if the patient suffers from chronic pain or quality of life is negatively affected.

According to recent studies, the principal risk factors are the following:

• Sex. Trigeminal neuralgia is more frequent in women than in men and is more common after 35 years of age. However, there is a higher incidence in men over 80 years of age.
• Age. According to studies, the incidence of neuralgia increases with age, beginning between 50 and 60 years of age. In people between the ages of 60 and 69, the incidence is 17.5% among 100,000. After 80, this number increases to 25.9%.
• Genetics. It has been shown that patients who have a family history of TN have a 5% probability of suffering from this condition. 

Additionally, there are some conditions and habits that have been linked to the appearance of trigeminal neuralgia pain. These include:

• Multiple Sclerosis.
• Aneurysm.
• Dental infection.
• Arterial hypertension.
• Brain tumor.
• Lacunar infarcts. 
• Consumption of alcohol and tobacco. 

The first step in diagnosing trigeminal neuralgia is to analyze the patient’s medical history and determine if there is an external factor that is causing the condition such as a frequent habit or activity or an illness. It is also necessary to rule out any other disorders that could be causing the facial pain. These include the following:

• Temporomandibular Joint Disorder (TMD)
• Postherpetic neuralgia (also known as nerve pain after an outbreak of shingles)
• Headaches (due to a condition such as migraines or other psychological factors, including stress)  

Diagnosing trigeminal neuralgia is usually a complicated process. The diagnosis can be influenced by several factors and/or disorders that provoke similar symptoms. For this reason, the best advice is to seek the support of a dentist specialized in trigeminal neuralgia, especially if signs of TN are present.    

You can diagnose your condition at the Clínica Dental Gil Escazú y Clínica Gil San Pedro with a specialist in trigeminal neuralgia.

Patients who suffer from trigeminal neuralgia frequently receive medical or surgical treatment according to the level of pain they experience. 

Currently, there are several treatment options. These include taking medication along with multifocal treatment as well as other complementary approaches. 

In general terms, it is advised to follow a balanced diet and receive physical therapy that includes physiotherapy in order to improve and stimulate the facial muscles as well as blood circulation in the trigeminal nerve. 

The following are treatments that improve trigeminal neuralgia symptoms:

Medication

• Anti-seizure medicine. This medication helps block the activation of nerves. This is a good alternative to reduce pain attacks.
• Anti-depressants. Anti-depressants, especially the tricyclic type, are an excellent ally in treating pain in patients who frequently suffer from TN.
• Analgesics. Common analgesics such as opiod drugs can help patients who suffer from mild pain. However, they are not commonly prescribed for severe cases.
• Anesthesia. This type of treatment can block the nerve and mitigate the pain. 

Surgery

Surgical procedures are usually the last option in treating trigeminal neuralgia when medication does not work. 

If the following symptoms are persistent (sharp pain, cognitive impairment, memory loss, excessive fatigue, bone marrow suppression or allergies), the patient should consult a specialist to determine if surgery is a suitable option for him or her.

For more information about the latest recommended treatments, consult a specialist in trigeminal neuralgia in order to receive assistance and medical attention.

Schedule an appointment with our specialists in trigeminal neuralgia.  

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What foods should I avoid if I have trigeminal neuralgia?

Cold foods should be avoided. Trigeminal neuralgia can cause sensitivity to cold, whether it be food or metal utensils. For more information, we recommend you consult a specialist in trigeminal neuralgia. 

How long does it take to recover from trigeminal neuralgia?

To date, there is not treatment that completely eliminates trigeminal neuralgia. With medical assistance, it is possible to control the symptoms so that the episodes become less painful. In some cases, the symptoms can disappear for months or even years. 

Which muscles are affected by trigeminal neuralgia?

Neuralgia does not directly affect muscles nor does it produce facial paralysis. In fact, it has not been associated with loss of sensation or with loss of mobility. However, this condition can become worse if muscle pain is present. 

Does trigeminal neuralgia affect one’s vision?

No. Nevertheless, because trigeminal neuralgia produces chronic pain, it can raise arterial pressure and cause blurred vision. However, there are no studies that link this condition with vision loss.