Castro Domínguez Francisco

Trigeminal neuralgia is a neurological disorder characterized by severe, sudden-onset, and recurrent facial pain. This condition is often described as one of the most excruciating pains a person can experience.

Presentation Symptoms:

Sudden, Severe Facial Pain: Trigeminal neuralgia typically involves intense, stabbing, or electric shock-like pain in the face, usually on one side. The pain is often triggered by mild stimulation of specific areas of the face, such as speaking, eating, drinking, or even a gentle touch.

Episodic Pain: The pain typically occurs in sudden and recurrent attacks, with each episode lasting from a few seconds to a couple of minutes.

Triggers: Common triggers include eating, talking, smiling, touching the face, exposure to cold air, and even slight movements of the facial muscles.

Unilateral Pain: The pain is usually confined to one side of the face, following the distribution of the trigeminal nerve.

Pain-Free Intervals: Between attacks, individuals with trigeminal neuralgia often experience pain-free intervals.

Diagnosis:

Clinical Assessment: A healthcare provider will take a detailed medical history and conduct a physical examination to assess the patient's symptoms, pain triggers, and any sensory abnormalities in the face.

Imaging Studies:

Magnetic Resonance Imaging (MRI): An MRI of the brain and the trigeminal nerve is often performed to rule out other potential causes of facial pain, such as a tumor or multiple sclerosis.

Neurological Evaluation: Neurological tests may be conducted to evaluate sensory and motor function in the face.

Treatment:

Medications:

Anticonvulsant Medications: Medications like carbamazepine or oxcarbazepine are often the first-line treatment for trigeminal neuralgia. They help control nerve firing and reduce pain.

Baclofen: This muscle relaxant may be used in combination with anticonvulsants to alleviate symptoms.

Surgical Interventions:

Microvascular Decompression (MVD): In this surgical procedure, a neurosurgeon repositions or removes blood vessels or arteries that may be compressing the trigeminal nerve. MVD is often highly effective in providing long-term relief.

Radiosurgery: Stereotactic radiosurgery, such as Gamma Knife radiosurgery, delivers highly focused radiation to the trigeminal nerve, reducing pain signals.

Balloon Compression: This procedure involves inserting a balloon into the trigeminal nerve and inflating it to damage the nerve fibers, reducing pain signals.

Radiofrequency Ablation: A needle with an electrode tip is inserted near the trigeminal nerve and heated to create a lesion that disrupts pain signals.

Glycerol Injection: A glycerol injection can damage the trigeminal nerve and reduce pain.

Nerve Blocks: Nerve blocks using medications like lidocaine or Botox can be used to provide temporary relief by numbing the trigeminal nerve.

Alternative Therapies: Some individuals explore complementary treatments such as acupuncture, biofeedback, or relaxation techniques to help manage pain.