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Trigeminal Neuralgia

Have your face been in extremely painful condition? Probably you have a facial pain which is called Trigeminal Neuralgia (TN).

TN affects one of your largest nerves inside your head, the trigeminal nerve. This causes painful facial pain.

During the 18th century, Nicolaus Andre ( a French surgeon) named TN as tic douloureux (painful spasm). TN is also known as the most terrible pain known to man in early medical literature.

At the moment, TN still the most frequent facial pain and affects 3 to 6 people out of 100,000 annually. Most importantly, the incidence of TN increases along with the age.

50-year-old is usually the age at onset. TN disorder is more common in females, possibly because women tend to live longer than men, statistically.

Even if TN is known as one of the most painful afflictions, it is not fatal.

Definition
What is Trigeminal Neuralgia (TN)? TN is a painful condition characterized by lancinating (lightning-like) attacks of severe facial pain.

TN happens due to the disorder of the trigeminal nerve (the fifth cranial nerve).

There are two trigeminal nerve located in different areas. They are located on each side of the head.

These trigeminal nerves responsible in sending the following impulses:

  • Pain
  • Pressure
  • Touch
  • Temperature to the brain from the face, forehead, around the eyes, jaw and gums

Trigeminal nerve is also being the mediator of the pain by headache.

The diagnosis of TN primarily based on the history and neurological examination.

Symptoms
The classic symptoms of TN are as follows:

  • Lancinating (lightning-like)
  • Excruciating
  • Intense
  • Happens suddenly
  • Unilateral face pain where the branches of the nerve are distributed
  • Lasts for several seconds to several minutes
  • May repeat several times a day for weeks or even months and then stop. TN might continue again after a period of time.

Typical triggers of TN are as follows:

  • Touching the face
  • Washing the face
  • Shaving
  • Brushing the teeth
  • Eating or drinking hot or cold substances
  • Talking
  • Yawning
  • Jarring the head

The point is, TN may occur spontaneously by sensory stimulation of areas in your face (forehead, lip, cheek, chin, tongue and others).

Diagnosis
The diagnosis of TN is often difficult because of the wide variety of facial pain. Therefore, the diagnosis lies on the ability of the clinician or the doctor to recognize a specific pattern.

White and Sweet in their writing titled Pain and the Neurosurgeon helped in defining diagnostic criteria for TN. They identified five main clinical findings:

  • Pain is unilateral
  • Pain is paroxysmal
  • Pain is confined to the trigeminal distribution
  • Pain may be provoked by tactile triggers (light touch to the face)
  • Clinical sensory examination is normal

The criteria above were a great advance facilitating research and enabling accurate and early clinical recognition to TN syndrome.

At the present time, TN is divided into two groups.

Classical (primary)

Classical TN happens when the underlying cause is not known. Majority of TN sufferers are inside this category.

Symptomatic TN

Symptomatic TN happens when TN patients show the symptom of another disorder, such as trigeminal root, cerebellopontine angle, or multiple sclerosis and benign tumors of the Gasserian ganglion.

In the next article, we will write about causes of TN and related disorders.

Kindly bear in mind that this article is not intended to be the only source of information about Trigeminal Neuralgia (TN) and the diagnosis of TN. You better consult with your doctor and other healthcare professionals in order to get a better knowledge and information about TN and how it is diagnosed.

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