Trigeminal Neuralgia


What should I do about trigeminal neuralgia of the teeth?
Trigeminal neuralgia in the teeth is generally caused by lesions in the areas controlled by the trigeminal nerve, leading to pain. This pain has trigger points, which could be a particular patch of skin or triggered during face washing, producing paroxysmal, electric shock-like pain. It is important to differentiate this from tooth-related nerve pain. Sometimes toothache may resemble symptoms of trigeminal neuralgia. If dental treatment does not relieve the pain, it might be trigeminal neuralgia related to the teeth. Trigeminal neuralgia requires medication, and there are many types of treatments available. If medicinal treatment proves ineffective, surgical treatment or acupuncture may be employed. In severe cases, nerve tissue blockage can be performed to temporarily relieve the pain.


Trigeminal neuralgia symptoms display
Trigeminal neuralgia typically manifests as sudden, severe facial pain, most often occurring in areas such as the upper lip, nostril, or corner of the mouth. These areas are prone to forming trigger points, and touching or stimulating these points can provoke an episode of pain. Most often, pain attacks occur when the patient is talking or eating, causing sudden cessation of the activity. The patient may experience unilateral facial muscle spasms, and reactions such as frowning, clenching teeth, opening the mouth wide, covering the eyes, or vigorously rubbing the face with the palm of the hand, leading to rough, thickened skin and eyebrow hair loss.


Can trigeminal neuralgia be cured completely?
Trigeminal neuralgia manifests as stubborn, intractable pain, but that does not mean we are helpless against it. The treatment of trigeminal neuralgia mainly involves the following aspects. Medication can only relieve symptoms and is not a cure. Radiofrequency ablation can destroy the trigeminal ganglion, but there is also a high probability of recurrence. The principle of Gamma Knife is somewhat similar to radiofrequency ablation, and the possibility of recurrence is also relatively high. Currently, the most effective treatment for a complete cure is surgical treatment, with about 80%-90% of patients with trigeminal neuralgia achieving complete eradication through treatments such as microvascular decompression surgery.


Early manifestations of trigeminal neuralgia
For patients with trigeminal neuralgia, the initial symptoms mainly include sudden onset of intense pain that stops abruptly. The nature of the pain is generally sharp, resembling sharp stabbing or knife-like pain. In most cases, trigger points are easily formed on the face, commonly appearing around the bilateral nostrils and corners of the mouth as fixed trigger points. Touching these trigger points can easily trigger an attack of trigeminal neuralgia, which lasts for a relatively short duration, typically from a few seconds to several seconds. In most cases, attacks are more likely to be triggered when the patient is tired, fatigued, or under mental stress.


Is occipital neuralgia the same as trigeminal neuralgia?
Occipital neuralgia and trigeminal neuralgia are different; these are two distinct diseases with different onset times, affected areas, and pain characteristics. Occipital neuralgia generally occurs in the back of the head and is associated with cervical spondylosis, neck muscle tension, spasms, injury, trauma, and inflammation, typically triggering pain in the distribution area of the greater occipital nerve. Trigeminal neuralgia generally affects the distribution area of the trigeminal nerve, causing very intense pain, which may be like lightning or a burning sensation. It is typically triggered by washing the face, brushing teeth, or touching and can start and stop suddenly.


Is cold compress effective for trigeminal neuralgia?
Trigeminal neuralgia is a type of intense recurring pain in the facial areas distributed by the trigeminal nerve. When an attack occurs, the pain is unbearable for the patient. Clinically, besides immediately taking medication or opting for surgical treatments after stabilization, applying a cold compress can also alleviate symptoms. Placing a cold towel on the painful facial areas can relieve spasms and pain, improve local swelling, raise the pain threshold, and subsequently reduce the sensation of pain.


trigeminal neuralgia area
The trigeminal nerve, being the fifth pair of cranial nerves, branches into three divisions after emerging from the skull. The first division is the ophthalmic division, which innervates the upper eyelid and superficial parts of the eye and forehead. The second division is the maxillary division, governing the cheek, upper lip, and gums. The third division is the mandibular division, which affects the lower lip and gums. Trigeminal neuralgia is pain that occurs in the areas innervated by the trigeminal nerve, typically affecting one side and primarily involving the second and third divisions, with the second being the most common and the third next, while the first division is rare. The pain of trigeminal neuralgia can be confined to the area of one division or can occur in two or all three divisions simultaneously.


Trigeminal neuralgia pain level
The World Health Organization classifies pain into five levels. Level zero is no pain. Level one is mild pain that does not require medication. Level two is moderate pain that requires medication. Level three is severe pain that necessitates medication. Level four involves severe and intense pain, often accompanied by changes in vital signs such as blood pressure, pulse, and respiration. Trigeminal neuralgia is a type of severe pain that occurs repeatedly in the trigeminal nerve area. It is recognized globally as one of the most painful diseases, often referred to as the "world's greatest pain" and "the cancer that does not kill." Patients often live in a state of feeling better off dead, which indicates the extreme level of pain associated with this disease. The pain level for this condition is classified as level four, the highest level.


Is trigeminal neuralgia dangerous?
Trigeminal neuralgia manifests in the regions of the face covered by the distributions of the trigeminal nerve, featuring recurrent, severe pain. The onset of the disorder is sudden and it resolves quickly as well. The pain is usually described as cutting, electric shock-like, burning, or tearing; it is a stubborn, difficult-to-treat pain, colloquially known as the "king of pain" and "the foremost pain in the world," which reflects the extreme level of pain associated with trigeminal neuralgia. Trigeminal neuralgia is generally not fatal, but it inflicts significant harm on the human body, making sufferers feel as if death would be preferable. It causes substantial psychological and physical obstacles and can even trigger the onset of some cardiovascular and cerebrovascular diseases, potentially leading to sudden death. Thus, trigeminal neuralgia is considered a rather dangerous disease.


Causes of Trigeminal Neuralgia
At present, there is no consensus on the specific causes of trigeminal neuralgia. Most scholars believe that the main cause of trigeminal neuralgia is still due to the presence of a local responsible blood vessel around the trigeminal nerve, which compresses the trigeminal nerve, leading to abnormal discharges of the trigeminal nerve. This results in sudden attacks and sudden stops of severe, knife-like or burning pain, also known as trigeminal neuralgia. In terms of treatment, it mainly involves active drug therapy and some physical therapies, such as massage, manipulation, physiotherapy, and acupuncture. Most patients who experience poor results from conservative treatments can opt for microvascular decompression surgery, which often achieves good therapeutic outcomes.