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Trigeminal Neuralgia

What is Trigeminal Neuralgia?

Trigeminal neuralgia is one of the most painful conditions ever described; inducing crippling, shock-like stabbing and/or throbbing facial pain.

Typically, this is on one side of the face, although in very rare instances, both sides may be affected. When both sides of the face are involved, it is known as bilateral trigeminal neuralgia.

Trigeminal neuralgia gains its name from the name of the nerve involved, i.e. the trigeminal nerve and also from "neuralgia" meaning a severe stabbing pain often related to a nerve.

What Will Trigger a Bout of Pain?

During bouts of trigeminal neuralgia ordinary stimuli such as touch, talking, eating or even the light brush of your own hair against your face will initiate bouts of very intense, burning, electric-shock-like pain, lasting from several seconds to minutes at a time.

The period of time when the pain subsides are generally very short-lived, typically from a few seconds to a few minutes before another stimulus and therefore another excruciatingly painful attack.

What Causes Trigeminal Neuralgia?

The exact cause of trigeminal neuralgia still remains a mystery. Some authorities on cranial nerve conditions such as trigeminal neuralgia, suspect that compression of the trigeminal nerve by a vein or an artery is the main cause although direct injury to the trigeminal nerve, the 5th of the 12 pairs of cranial nerves, can also cause the onset of this type of neuralgia.

Other authorities cite the Herpes virus (HHV6) as the cause of trigeminal neuralgia.

Nerve Affected

Affecting the 5th cranial nerve, the relatively rare condition falls under the umbrella term of facial neuralgia.

Normally, in medical literature, the trigeminal nerve is referred to as 'cranial nerve V', the 'V' standing for the Roman numeral for 5.

The trigeminal nerve branches into 3 subsets:

• V1 - Ophthalamic - this 1st branch supplies the eye, forehead and nose.
• V2 - Maxillary - the 2nd branch of the trigeminal nerve, this supplies the upper teeth, gum and lip, the cheek, lower eyelid and the side of the nose.
• V3 - Mandibular - the 3rd branch of the trigeminal nerve supplies the area of the lower teeth, gum, lower lip and jaw.

Summary of Proposed Causes of Trigeminal Neuralgia

Summary of causes thought to be responsible for trigeminal neuralgia:

• Pressure exerted by an artery of vein on any of the areas involved in control of the trigeminal nerve (Cranial V)
• Multiple Sclerosis. Approx. 5 - 10% of patients with MS experience trigeminal neuralgia. This is thought to be due to demyelination of the trigeminal nerve nucleus within the brainstem, or the trigeminal nerve itself.
• Herpes Simplex virus - HHV6 is thought by some authorities to be the organism responsible for trigeminal neuralgia.
• Tumour - extremely rare. Neoplastic (new) growth - i.e. - the tumor, exerts more and more pressure on the trigeminal nerve or the trigeminal nerve nucleus.
• Physical injury or irritation - perhaps due to a blow to the head area or from dental procedures