Trigeminal neuralgia affects an estimated 4.5 per 100,000 individuals every year. It is characterized by sudden, violent, and often excruciating outbursts of facial pain. These are referred to as ‘paroxysms’ and are often triggered by common daily tasks. These include actions like washing your face and brushing your teeth. Likewise, these can be triggered by simple actions like chewing or smiling.
Trigeminal neuralgia is typically caused by compression or infection of one of the divisions of the trigeminal nerve. The trigeminal nerve is located at the base of the brain, and is responsible for feelings of sensation from the different parts of the face. The first option of treatment is drug therapy. Typical drugs include carbamazepine, oxcarbazepine, baclofen, lamotrigine, pimozide, and phenytoin. The appropriate medicine will be determined by your doctor.
If drug therapy fails, surgical intervention is an option. Microvascular decompression is a procedure that attempts to relieve pressure on the trigeminal nerve. Other surgical options are targeted towards severing the problematic nerve(s) and include radiofrequency thermal rhizotomy, gamma knife radiosurgery, and peripheral neurectomy.
George Goshua, Justin F. Fraser, MD
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