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Trigeminal Neuralgia

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Trigeminal Neuralgia

Introduction

Trigeminal Neuralgia (TN) is where pain is experienced in the face. Often this pain is reported as being the worst kind of pain ever experienced by humans. This pain can be described as electric shocks which can make the patients grimace. Symptoms can last up to 2 minutes with ache, sensitivity and soreness after the attack.

Anatomy & Triggers

Most commonly, this pain affects one side of the face, following the distribution of the 5th cranial nerve the ‘Trigeminal nerve’.

 

The pain is mainly felt in the upper and lower jaw.

 

The Trigeminal nerve has 3 main branches

  1. Opthalmic – (around the eye)
  2. Maxillary – (upper Jaw)
  3. Mandibular – (lower Jaw)

 

Pain triggers can include touching the face, shaving, rubbing the face, eating, talking and the cold.

Pathology

Symptoms are usually caused by the compression of the Trigeminal nerve root. Compression can be caused by collections of blood vessels, tumours, inflammation, trauma and diabetes. TN can also be a complication of multiple sclerosis and other neurological conditions which cause de-myelination of the nerve root.

Epidemiology

TN affects 4.5 people in 100,000, those mainly being women between the age of 60-70 years.

Management

Medical 

Commonly a range of anti-epileptic medications are used to help control pain. And other medications along side them that are prescribed by the GP or specialist.

 

Surgical 

It is suggested that approximately 25% of patients may need surgery as the condition worsens. This is considered with the help of a specialist.

 

Physiotherapy

Specialist Physiotherapy assessment can help identify your triggers, the nerves affected, education on the condition, strategies to help manage your attacks, relaxation techniques, acupuncture and advice on cardiovascular exercise. We can also assist with sign posting you to support groups.

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