It is a chronic pain condition that affects the nerve, which carries sensation from the face to the brain. The nerve is called trigeminal nerve. Even mild stimulation of the face can result in a jolt of excruciating pain. Women are more commonly affected. Usually seen in people more than 50 years of age.
What are the symptoms?
Episodes of severe shooting or jabbing pain resembling electric shock
Attacks triggered by touch, chewing, brushing or speaking
Pain usually lasts for a few seconds to a minute
Remissions and relapses
Pain only in the area supplied by trigeminal nerve
Mostly on one side of face
Pain usually starts from one fixed spot
Attacks become more frequent and intense over a period of time
What are the causes?
The main cause is a conflict between the nerve and a blood vessel close to it. This contact puts pressure on the nerve causing it to malfunction
Very rarely trauma and stroke
Neurologic disorders like multiple sclerosis
Very rarely tumor compressing the trigeminal nerve
What triggers the pain?
Touching the face
Eating and drinking
Brushing the teeth
Washing the face
Smiling and talking
How do u diagnose?
Detailed history and clinical examination
MRI to see for the neurovascular conflict
How does one treat?
Medications like anticonvulsants and muscle relaxants
Glycerol injection into the nerve at the base of the brain
Balloon compression where a balloon is taken to the base of the brain and kept inflated to damage the nerve
Radio frequency thermal lesioning where the nerve fibers are damaged with thermal energy
Gamma knife focused radiation
Surgery is called micro vascular decompression where the nerve and the vessel are separated by a piece of Teflon placed between them to keep them separated. This entails opening the skull.