Is trigeminal neuralgia severe?

Written by Jiang Fang Shuai
Neurosurgery
Updated on September 06, 2024
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Trigeminal neuralgia is one of the most common, stubborn, and excruciatingly painful diseases, known by patients as the "world's most severe pain." The intensity of the pain during an episode can surpass even that of childbirth. When the pain is severe, patients dare not speak, eat, or sleep, causing immense suffering in their lives. In extreme cases, the unbearable pain leads to suicidal thoughts. Therefore, trigeminal neuralgia is also referred to as the "non-lethal cancer," a serious neurological disorder.

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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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Trigeminal neuralgia physiotherapy methods

For patients with trigeminal neuralgia, in addition to pharmacological treatment, some physical therapies can also be combined, such as massage, acupressure, physiotherapy, acupuncture, and electrotherapy. These physical therapies can help reduce the incidence of trigeminal neuralgia and improve symptoms. It is recommended to undergo physical therapy under the guidance of a professional physician, which can play a supporting role. Of course, physical therapy cannot replace surgical treatment. If the goal is complete treatment, it is advised to undergo microvascular decompression surgery, which plays a crucial role in alleviating pain and stabilizing the condition. (Please use medication under the guidance of a professional physician and do not self-medicate.)

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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.

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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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Radical treatment method for trigeminal neuralgia

The fundamental cause of trigeminal neuralgia lies in the compression of the trigeminal nerve root by aberrant blood vessels around the area where it exits the brain stem. This compression leads to demyelination of the trigeminal nerve and causes a short circuit in the trigeminal nerve conduction pathway, resulting in trigeminal neuralgia. Currently, the only definitive cure for trigeminal neuralgia is microvascular decompression surgery. This surgery addresses the cause of trigeminal neuralgia by opening the skull, locating the trigeminal nerve and the compressing vessel, and placing a cushion between the nerve and the vessel to achieve a cure. This type of surgery is characterized by minimal trauma, preservation of nerve function, rapid recovery, and low complication rates, making it the best treatment for trigeminal neuralgia that can achieve a definitive cure.