|
Trigeminal Neuralgia
Trigeminal neuralgia refers to the SUDDEN onset of sharp, episodic pain to a specific nerve which enervates the face. The trigeminal nerve supplies the cheek, forehead, and area around the mouth with sensation (feeling). There is a trigeminal nerve on each side of the face, each supplying one half of the face. A temporary, seizure-like dysfunction of this nerve can send "ripping", electric shock-like pain, into the area adjacent to one eye or the cheek. The exact cause of trigeminal neuralgia is not known, but may be a form of seizure disorder. Multiple sclerosis must be considered in the 20-30 year old with trigeminal neuralgia. Common symptoms include: painful attacks that last a few seconds to a few minutes. Each attack may be separated by a minute or two of complete absence of pain. With time, these volleys of pain are said to become MORE frequent. Victims of this disease are rumored to consider suicide as an alternative to suffering from this intense pain. Physical examination of these patients commonly reveal "trigger points." These are small areas around the lips, on the gums, or just under the nose that, when touched, will generate an attack. Evaluation is by history and physical examination (searching for trigger points). The diagnosis can usually be made by history and physical exam alone. A trial use of anticonvulsant medications that decreases the painful attacks is considered diagnostic for this condition. Treatment is with certain anticonvulsant medications (e.g. carbamazepine). Some neurosurgical procedures have been introduced for the treatment of this condition. A Neurologist is the expert in the evaluation and medical management of this problem. A Neurosurgeon will be consulted in those cases that fail medical management.
|
