Trigeminal Neuralgia is also known as Suicide Disease. The name will itself give you an idea of how severe this disease could be. There was a time when there was no answer to this pain, and this facial pain was so severe that people who were having this disease used to commit suicide to get rid of it. This is the worst pain ever experienced by mankind.
What is trigeminal neuralgia?
The Trigeminal is a sensory nerve that is responsible for carrying sensation from the face to the brain. If we decide the face into parts, then there would be three parts of the face.
The nerve divides the face into three parts; hence it is known to be a “tri” geminal nerve, and the pain in this nerve is known as Trigeminal Neuralgia. The pain stimulates like a current. The typical trigeminal neuralgia is:
- It is sudden when it starts
- It comes like a current
- It lasts for few seconds or sometimes or a few minutes
- It is extremely severe
- It has got specific trigger factors like eating, chewing from that side, drinking water, speaking, touching the face with a hand or towel, travelling in a two-wheeler or four-wheeler can also trigger the pain.
Many people complain that the pain either started from the upper gum or lower jaw and the lower gum or lower jaw, and slowly this current flows up or down, throughout the nose, or throughout the front of the ear.
In many parts of the world, people are diagnosed wrongly, considering this pain to be a dental issue or teeth are removed for this. This is very commonly seen in trigeminal neuralgia. This needs to be educated to both the common public and the neurosurgical doctor as well.
Causes of Trigeminal Neuralgia
In the majority of the patients, except for the tumours or medical conditions like multiple sclerosis, the commonest cause of Trigeminal Neuralgia is Neurovascular Conflict. This is a blood vessel burring deep into the nerve, and in this case, it is the trigeminal nerve.
In hemifacial spasm, when the face twitches a bit, the vessel burrows into the facial nerve. But in the trigeminal neuralgia, it burrows into the trigeminal nerve and with each pulsation, it goes on, hitting the nerve even more.
Hence the nerve becomes deceased because of the pulsatile compression almost 70 to 80 times every minute. And eventually, the pain attacks start. This is the cause of Trigeminal Neuralgia.
Symptoms of Trigeminal Neuralgia
The symptoms of Trigeminal Neuralgia is current, like painful attacks. They are similar to the effect of throwing chilli powder suddenly in the eyes or the face. This is much similar to the burning of multiple pinpricks coming. There are different symptoms by which people persuade this pain.
Trigeminal Neuralgia usually starts with attacks of small duration, and eventually, it goes on increasing the duration. If this is not treated at the proper time, it converts into Type-2 Neuralgia, i.e., there is continuous pain in the background, and with that background, you may get certain attacks of pain. This is even a worse condition.
Side effects
Initially, doctors might start with a few medicines, but they may not be responsible for treating the basic cause of the pain.
These medicines will numb the nerve as they tend to work like a nervous system painkiller or numbing agent, or antiepileptic agents used for pain. These agents are unable to figure out that they only have to target the trigeminal nerve; hence they affect the entire nervous system. Some of the side effects are:
- Loss of balance while walking
- Memory and concentration issues
Initially, when small doses are used to treat the pain, you may carry on with your normal activities. But as the intensity of the pain increases, the doses of the medicine also tend to go up. And it is commonly seen that extreme pain catches you on one side and with the problems of the painkillers on the other side. You will be sandwiched between the devil and the deep sea.
Treatment
The answer to Trigeminal Neuralgia is Microvascular Decompression Surgery. Hereunder the illumination of the neuron microscope, doctors descend out the artery from the nerve, and they wrap it with a Teflon sponge.
Eventually, the pulsation stops affecting the nerve when it is done. This is definitely a difficult treatment treating the cause at its root other than any superficial bandaid being applied.
There are some other methods as well as some controversies in some areas like Radio Frequency Lesioning Treatment, in which a needle is put inside the nerve and burns the nerve in that area.
There is also balloon decompression treatment. It is a treatment in which a balloon is passed deep into the nerve, and it is inflated, and the nerve is damaged or purposefully. There is also Gamma Knife Treatment in which the rays burn the nerve from outside.
All these procedures are peripheral procedures as they are not targeting the exact cause of the problem. In a sense, they are all destructive procedures. They are mostly to be short-lived.
Scientifically proven, the highest success rate is from Microvascular Decompression Surgery. For many years doctors have been treating Trigeminal Neuralgia with Microvascular Decompression Surgery. The results of this surgery become much better, and there are also fewer chances of complications. There is a 98% success rate with Microvascular Decompression Surgery.
Doctors are also concentrating on treating this pain with utmost care; at the same time, they are also educating people that MVD surgery is probably the only method that targets the root cause of Trigeminal Neuralgia directly. Statistically, around the entire world, this method has also got the highest chance of cure. Doctors also make sure that nobody should be kept away from this information.
Conclusion
The final decision always depends upon the patient and which method they are going to opt for. But it should never happen that they are not aware of the diagnosis.
According to reports, many of the patients who were initially not aware of the treatment assured them that they would opt for the MSD treatment after getting proper knowledge of it. This also indicates why Trigeminal Neuralgia is known to be a suicide disease.
Try to spread this knowledge to as many people as possible and help them get treated as cured.