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Trigeminal Neuralgia

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Introduction

Trigeminal Neuralgia (TN) is where pain is experienced in the face.

Signs & Symptoms

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.

Causes

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)

 

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

Prevalence

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

Assessment & Diagnosis

Specialist Physiotherapy assessment can help identify your triggers and the nerves which may be contributing to your symptoms. Being provided with a timely diagnosis will ensure the most effective treatment and management plan can be implemented straight away. Your Physiotherapist will work with you to set goals based on what is important to you and will tailor your treatment to those aims.

Self-Management

Your Physio will provide you with education on the condition, strategies to help manage your attacks, relaxation techniques and advice on cardiovascular exercise to maintain your health and well-being. 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 – this is something your clinician can discuss with you.

Physiotherapy

Your Physiotherapist may use manual therapy techniques and acupuncture to help reduce your symptoms and restore function. They will also prescribe exercises that can help further reduce pain and maintain function. Regular re-assessment will ensure you are making progress and your Physio will provide ongoing support so you can continue to manage your symptoms.

Escalation of Treatment

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

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