Is trigeminal neuralgia severe?

Written by Jiang Fang Shuai
Neurosurgery
Updated on September 05, 2024
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Trigeminal neuralgia is often described by people as the "world's first pain," highlighting the severity of this condition. Patients usually experience excruciating pain in the areas of the head and face served by the trigeminal nerve during activities such as washing their face, brushing their teeth, eating, drinking, combing their hair, and even in a state of rest. The pain can feel like cutting, burning, tearing, or electric shocks, making it unbearable and extremely agonizing. Clinically, trigeminal neuralgia is characterized by a sudden onset, long duration of illness, and a very slow, or even impossible, recovery. Therefore, those suffering from trigeminal neuralgia often face tremendous physical and psychological challenges. It is a serious disease.

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Written by Shu Zhi Qiang
Neurosurgery
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How is trigeminal neuralgia diagnosed?

Trigeminal neuralgia is divided into primary and secondary types. Primary trigeminal neuralgia refers to cases where no specific cause is apparent. However, with the advancement of modern medicine, doctors have discovered that there is actually a cause for primary trigeminal neuralgia. It is due to the lack of protective myelin sheath over the initial segment of the trigeminal nerve, which gets irritated by the pulsation of nearby small arteries. In such cases, further investigations like brain MRI and cerebral angiography can usually identify the responsible blood vessel. On the other hand, secondary trigeminal neuralgia occurs along with corresponding tumors and inflammation during the progression of the neuralgia, and MRI can assist in diagnosis.

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Written by Jiang Fang Shuai
Neurosurgery
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Is trigeminal neuralgia severe?

Trigeminal neuralgia is often described by people as the "world's first pain," highlighting the severity of this condition. Patients usually experience excruciating pain in the areas of the head and face served by the trigeminal nerve during activities such as washing their face, brushing their teeth, eating, drinking, combing their hair, and even in a state of rest. The pain can feel like cutting, burning, tearing, or electric shocks, making it unbearable and extremely agonizing. Clinically, trigeminal neuralgia is characterized by a sudden onset, long duration of illness, and a very slow, or even impossible, recovery. Therefore, those suffering from trigeminal neuralgia often face tremendous physical and psychological challenges. It is a serious disease.

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Written by Li Pei
Neurosurgery
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How is trigeminal neuralgia treated?

After the onset of trigeminal neuralgia, medication is the first choice of treatment. If the effect of medication is poor, surgical treatment can be considered. There are two methods of surgical treatment. One is radiofrequency treatment, which physically destroys the trigeminal nerve but often relapses after surgery. The other method is microvascular decompression surgery of the trigeminal nerve under a microscope. This surgery requires craniotomy under general anesthesia. Under the microscope, the trigeminal nerve and the blood vessel pressing on it are identified, and then a special material is used to separate the two, so the blood vessel cannot irritate the trigeminal nerve, and thus, the pain is alleviated.

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Written by Gao Yi Shen
Neurosurgery
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Will trigeminal neuralgia cause facial swelling?

Trigeminal neuralgia, if very severe, can also cause facial swelling. This is because the muscle tissue in the human body has a neurotrophic function, meaning that its nerves do not only play a controlling role but also have a nutritive function. If the pain from the trigeminal neuralgia is continuously severe, this can lead to the loss of the nutritive function, and over time it might cause muscle edema. Therefore, in such cases, it is crucial to promptly determine any changes in the condition and proceed with the necessary examinations and treatments early on to reduce problems of facial swelling caused by severe trigeminal neuralgia pain later. This often appears in the later stages and indicates that the condition has become relatively severe, requiring timely treatment.

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Written by Gao Yi Shen
Neurosurgery
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Is trigeminal neuralgia easy to treat?

Whether trigeminal neuralgia is easy to treat must be judged based on the situation at the time. The vast majority of patients with trigeminal nerve pain can find a corresponding cause, such as compression by blood vessels, tumors, or infection factors. For vascular compression, microvascular decompression surgery can be adopted for treatment. For tumor compression, craniotomy and tumor resection can be adopted for treatment. For some infectious factors, treatment such as anti-infection and hormones can be adopted. These are relatively easier to treat, and most can have a very obvious prognosis. However, there are also cases, such as trigeminal neuralgia where no specific cause has been found, called primary trigeminal neuralgia, where active complete treatment is not possible, and only certain methods can be used to alleviate the general symptoms of the patient and reduce their suffering.