Trigeminal neuralgia is a special case of nerve pain. It is often described as the “the world’s worst pain.” Typically, patients suffer from attacks of intense, electric shock-like facial pain along the trigeminal nerve.
Although the exact cause of trigeminal neuralgia is not fully understood, research indicates that the trigeminal nerve is damaged by a loss of myelin, in some cases caused by a blood vessel compressing the nerve. Other causes include multiple sclerosis, stroke, brain trauma and others.
Trigeminal neuralgia patients suffer from attacks of intense, electric shock-like facial pain along the trigeminal nerve. These attacks can occur without warning signs and last from seconds to minutes. In some cases, they might be trigger by touching the face, talking, eating, drinking, shaving or brushing teeth and other activities.
In case of trigeminal neuralgia, most important is a consultation with an experienced Neurologist. The clinical impression and physical examination are guiding the way. If the location is identified, certain nerve tests like Nerve Conducting Velocity or Electromyography may be used to verify the diagnosis or to determine the location precisely.
First line treatment for Trigeminal neuralgia are certain medications such as anticonvulsants, antidepressants, injections etc. Usually, those have a good response rate over 85%. Only in cases of remaining pain surgery should be considered. There are various types of surgery available nowadays. Most surgeries are leading to a complete destruction of the nerve, which causes facial numbness. Therefore, surgery should be only considered if all other treatment options failed.