A Painful Intrusion
As the image shows, the trigeminal nerve consists of a complex root and branch structure, underlying much of our face. The system is there to carry sensation messages to our brain but can at times malfunction.
The stabbing, burning, shock like pain which follows may be at extreme levels. Occasionally spontaneous, or brought on by applying make up, shaving, eating, drinking, smiling, any facial activity, or the environment.
There is no exact scenario for trigeminal neuralgia. More prevalent in later years but possible at any age, one side of the face being stricken is common but both can be, along with the oral area, jaw, eyes, or forehead.
Bouts can vary, from brief spasms, to longer lasting, or intermittent and in almost all cases, they deserve specialist medical support.
Precise diagnostic tests do not exist, discussing your symptoms with an experienced maxillofacial consultant is the best route. They can help to rule out causes other than TN, such as jaw joint, or wider nerve injuries.
Where the issue is with the trigeminal nerve, an MRI scan can be helpful, by picking up locations where the nerve is compressed.
This is most often caused by pressure from nearby blood vessels, or more rarely unknown tumours, or physical trauma. Damage to the myelin sheath which surrounds the nerve may be a further issue.
Multiple sclerosis can bring this type of damage, brain lesions and strokes are at times associated with trigeminal neuralgia, although the cause is more often independent.
Our maxillofacial consultant will discuss your health and medical history, alongside your physical examination and other diagnostic tests.
Trigeminal neuralgia is a variable condition where detail matters, understanding your unique issues is important for treatment decisions.
There are cases which will respond to oral, or injected medication. Microvascular decompression surgery can relieve compression of a nerve by an artery or vein.
Other surgical approaches could be appropriate in individual cases, or alternative medication, although both should be given careful thought.
The spasm like pain TN can bring is often hard to bear and may become more frequent, or intense over time. All the team at our London clinic recognise the seriousness of the condition and how much impact this has on life.
We also recognise that diagnosis, or solutions are not always straightforward. Even if no compression is visible, you could still have TN, treatment that works well in one case may not do so in another.
Analysis of your condition will help the specialist supporting you and bring informed decisions on treatment. There is often no need to be harried by a life of facial pain, when good care is available.