Causes of Trigeminal Neuralgia

Written by Chen Yu Fei
Neurosurgery
Updated on September 13, 2024
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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.

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What should I do if trigeminal neuralgia recurs?

After the recurrence of trigeminal neuralgia, oral medication can be considered as the initial treatment. If the effect of the medication is not clear, or the side effects are intolerable, then balloon compression or radiofrequency treatment can be considered. These two methods can be used repeatedly, but they also have a certain recurrence rate. If neither medication nor radiofrequency treatment achieves satisfactory results, then surgical treatment can be considered. Microvascular decompression surgery of the trigeminal nerve can be performed under a microscope, where the trigeminal nerve and the blood vessel compressing it are separated, which can fundamentally resolve trigeminal neuralgia. (Specific medications should be used under the guidance of a physician.)

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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
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Trigeminal neuralgia symptoms

Regarding the symptoms of trigeminal neuralgia, there is a very typical symptom, which is the issue of trigger points. A trigger point is a specific spot on the face, which varies for each person. Once this spot is touched, it immediately triggers the pain of trigeminal neuralgia. The nature of trigeminal neuralgia pain is often like cutting or stabbing pain, and the duration varies. If the condition is mild, the initial attack may only last a few seconds, but if the condition gradually worsens without significant improvement, the pain can even last for several minutes. This pain significantly impacts patients, sometimes triggering pain during activities such as brushing teeth, rinsing the mouth, or chewing hard food. Early treatment is essential to mitigate this pain.

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Written by Chen Yu Fei
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Does trigeminal neuralgia cause facial swelling?

For patients with trigeminal neuralgia, when they frequently experience bouts of pain, most do not have significant facial swelling. The pain typically occurs distinctly in the areas distributed by the trigeminal nerve roots, often starting and stopping suddenly, and each episode may last from a few seconds to several minutes. Due to repeated pain, facial muscle atrophy may occur, but generally, there is no swelling of the face. For treating trigeminal neuralgia, surgery is commonly used. Microvascular decompression surgery is often recommended to help improve symptoms and can even achieve a clinical cure.

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Written by Gao Yi Shen
Neurosurgery
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Trigeminal neuralgia should register for which department?

The department for registering trigeminal neuralgia depends on the distribution of departments in the local hospital. Most commonly, registration is done in the department of functional neurosurgery. However, different hospitals may have different levels of specialization and may employ varying treatment methods which require different departments. For instance, initially, one can register at the department of neurosurgery for oral medication adjustment, usually with carbamazepine. If there is no significant improvement later on, one may register with the department of pain management or anesthesiology for nerve block treatment. Due to the detailed specialization in some hospitals, it might also be necessary to consult other departments. If there is still no effective outcome, it is necessary to register at the department of neurosurgery for surgical treatment to fundamentally address the disease.