Trigeminal Neuralgia

Miami Neurosurgeon Dr. Azik Wolf Explains Trigeminal Neuralgia

What Are the Types of Trigeminal Neuralgia?

Trigeminal neuralgia may be progressive. This means that the symptoms may worsen over time. For example, initially, the pain may arise in the upper or lower jaw. Often this causes sufferers to think that the discomfort is due to a dental problem. Over time, the intervals between attacks may become shorter or may disappear altogether. Pain medication may also become less effective than it was initially.

Trigeminal Neuralgia Symptoms

Trigeminal Neuralgia generally results in debilitating pain on one side of the face originating in the jaw or lower half of the face. The sensation is often described as: burning pain, stabbing pain, aching pain, electric shocks, or toothache.

In the earlier stages of TN, you’ll experience brief periods of episodic pain lasting seconds at a time. Time be­tween episodes can vary from seconds to hours, or there can be days or months between attacks. 

Trigeminal Neuralgia Causes

Trigeminal Neuralgia occurs when the trigeminal nerve is compressed and becomes inflamed. Commonly, the compression is due to enlarged blood vessels that come in contact with the trigeminal nerve. It is not known why this may occur. Multiple Sclerosis and other conditions, such as optic neuritis or Devic’s disease,  that cause damage to the myelin sheath can also result in this condition. The myelin sheath is a sheet composed of lipids, proteins, and other substances that wraps around nerve fibers, providing insulation and protection, and enhancing electrical signals. Other causes include:

• Blood Vessels: Most cases of trigeminal neuralgia are caused by compression of the trigeminal nerve. This can happen when the blood vessels wrap around or grow over the nerve. Why this occurs is not understood.
• Brain Tumors and cysts: Tumors and cysts can either put pressure on the trigeminal nerve directly or can cause surrounding blood vessels to press against the nerve.
• Aneurysms: An aneurysm is a blockage or bulge in the wall of a blood vessel. This can also put pressure on the trigeminal nerve. 
• Virus: Viruses such as chickenpox, shingles, and herpes can also result in trigeminal neuralgia.
• Trauma: In some cases, trigeminal neuropathic facial pain may be a result of facial injury or trauma, stroke, or surgery on the ear, nose, or throat.

Trigeminal neuralgia may also be idiopathic, which means it may develop without any identifiable cause.

Trigeminal Neuralgia Risk Factors

Common risk factors associated with this condition include:

• Sex: Women are more likely to develop trigeminal neuralgia than men.
• Age: The risk of developing trigeminal neuralgia increases with age. It is higher in people who are between the ages of 50 and 60 years of age. This is mainly due to the elongation and hardening of the blood vessels and brain sagging, which can create new contacts between nerves and blood vessels.
• Multiple sclerosis: Multiple sclerosis is a chronic disease that can affect the brain, spinal cord, and optic nerves. Because it also affects the protective myelin coating of the nerves, it can lead to trigeminal neuralgia.