Trigeminal neuralgia prodrome

Written by Gao Yi Shen
Neurosurgery
Updated on November 14, 2024
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Trigeminal neuralgia does not have very obvious precursors. This is because trigeminal neuralgia often occurs suddenly, especially with the concept of trigger points. That is to say, once the trigger point is activated, it immediately induces pain without any warning signs. Trigger points vary from person to person, usually located primarily on the cheek. Patients who frequently suffer from trigeminal neuralgia often know these areas. Typically, the pain occurs during activities like brushing teeth with cold water or chewing hard foods such as peanuts or walnuts, triggering severe pain instantly. Thus, in the case of trigeminal neuralgia, there are no precursors, only immediate triggers and immediate pain.

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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.

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What are the symptoms of trigeminal neuralgia?

The clinical symptoms of trigeminal neuralgia are mainly characterized by severe, paroxysmal pain in the area of the face distributed by the trigeminal nerve, typically affecting one side. The pain can affect one, two, or all three branches of the trigeminal nerve. The pain is episodic, resembling cutting, electric shocks, and is sudden in onset and cessation, making it unbearable for the patient. In some patients, actions such as eating, washing the face, or brushing teeth can trigger the pain. Most patients have trigger points, commonly located near the nostrils, corners of the mouth, or upper lip.

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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.

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Written by Gao Yi Shen
Neurosurgery
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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 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.