Trigeminal neuralgia (TN) is a disorder of unilateral (usually right-sided) facial pain. While the exact cause is unknown, it is thought that TN results from irritation of the trigeminal nerve. This irritation results from damage due either to changes in the blood vessels or the presence of a tumor or other lesions that cause compression of the nerve.
The first symptoms of TN most commonly occur in persons over the age of 50, and affect women more often than men.
The pain of TN is characterized by unilateral pain attacks that start abruptly and last for varying periods of time from minutes to hours. The pain quality is usually sharp, stabbing, lancinating (cutting or tearing), and burning. It may have an "electric shock"-like character. The attacks are initiated by stimuli such as light touch of the skin, chewing, washing the face, and brushing the teeth. In some individuals the attacks may be initiated by non-painful physical stimulation of specific areas (trigger points or zones) that are located on the same side of the face as the pain.
Medical treatment is often very effective in controlling pain symptoms. In fact, the anti-seizure drug carbamazepine is so effective initially that the lack of response often calls into question the accuracy of the diagnosis.
For persons with continued pain after medical therapy, surgical options may be considered. These procedures have variable risks but may be very effective.
This MediFocus Guide contains an extensive listing of citations and abstracts of recent journal articles that have been published about this condition in trustworthy medical journals. This is the same type of information that is available to physicians and other health care professionals. A partial selection of journal articles that are abstracted in this MediFocus Guide includes:
Trigeminal neuralgia: opportunities for research and treatment. Pain. 2000
Acute and chronic craniofacial pain: brainstem mechanisms of nociceptive transmission and neuroplasticity, and their clinical correlates. Critical Reviews in Oral Biology & Medicine. 2000
On the natural history of trigeminal neuralgia. Neurosurgery. 2000
Trigeminal neuralgia: a diagnostic challenge. American Journal of Emergency Medicine. 1999
Medically unexplained chronic orofacial pain. Temporomandibular pain and dysfunction syndrome, orofacial phantom pain, burning mouth syndrome, and trigeminal neuralgia. Medical Clinics of North America. 1999
When is facial pain trigeminal neuralgia?. Postgraduate Medicine. 1998
Trigeminal neuralgia: mechanisms of treatment. Neurology. 1998
Trigeminal neuralgia. Primary Dental Care. 1997
Atypical facial pain and other pain syndromes. Differential diagnosis and treatment. Neurosurgery Clinics of North America. 1997
Neuronal hamartoma of the trigeminal sensory root associated with trigeminal neuralgia. Journal of Neurosurgery. 2000
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