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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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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Trigeminal neuralgia

Trigeminal neuralgia is very common in clinical practice and its pain is relatively severe. Most cases exhibit a cutting-like or electric shock-like pain, and sometimes burning pain can also occur. The pain process is often very painful, but once the nature of the pain disappears, there are basically no obvious clinical symptoms during the intermission period. Therefore, in practical work and learning, it is essential to avoid triggering trigeminal neuralgia, such as by reducing exposure to cold and hunger, and minimizing chewing hard foods, all of which can reduce the occurrence of trigeminal neuralgia. However, the most important point is that if trigeminal neuralgia persists, it is crucial to visit a hospital for appropriate diagnosis and treatment in order to achieve a relatively good therapeutic effect and reduce the patient's suffering.

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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.

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Does trigeminal neuralgia require craniotomy?

If the severity of trigeminal neuralgia is mild, oral medication can be chosen as the first treatment option. If the effects of the medication are not significant, radiofrequency treatment for the trigeminal nerve or balloon compression therapy can be considered, although these two methods do have a certain recurrence rate. If the effects of medications and treatments like radiofrequency are not significant, microvascular decompression surgery for the trigeminal nerve can be considered. This surgery requires general anesthesia and craniotomy, and under a microscope, the trigeminal nerve and the blood vessels compressing it are separated using a special material, which can relieve the pain of trigeminal neuralgia.

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Which hospital is good for trigeminal neuralgia?

For trigeminal neuralgia, it is generally recommended that patients seek medical advice from a prominent tertiary hospital early in the onset and consult a neurosurgeon to assess their condition. Once diagnosed with trigeminal neuralgia, initial treatment can often start with oral medication, which can relieve pain to a certain extent for most patients. However, medication alone rarely cures the condition completely. Clinically, it is typically recommended that patients undergo microvascular decompression surgery, which has satisfying therapeutic outcomes for most patients, gradually alleviating, or even eliminating, the symptoms of trigeminal neuralgia pain. Therefore, for such patients, early diagnosis and treatment are advised.