It has been described as among the most painful conditions known to mankind.
This disorder is characterized by episodes of intense facial pain that last from a few seconds to several minutes or hours. The episodes of intense pain may occur paroxysmally. To describe the pain sensation, patients may describe a trigger area on the face so sensitive that touching or even air currents can trigger an episode; however, in many patients the pain is generated spontaneously without any apparent stimulation. It affects lifestyle as it can be triggered by common activities such as eating, talking, shaving and brushing teeth. Wind, high pitched sounds, loud noises such as concerts or crowds, chewing, and talking can aggravate the condition in many patients. The attacks are said by those affected to feel like stabbing electric shocks, burning, pressing, crushing, exploding or shooting pain that becomes intractable.
Individual attacks usually affect one side of the face at a time, lasting from several seconds to a few minutes and repeat up to hundreds of times throughout the day. The pain also tends to occur in cycles with remissions lasting months or even years.
Many patients develop the pain in one branch, then over years the pain will travel through the other nerve branches.
It may slowly spread to involve more extensive portions of the trigeminal nerve. The spread may even affect all divisions of the nerve, and sometimes simultaneously.
The trigeminal nerve (cranial nerve V) is so named because it has three (tri) branches responsible for face sensation; one branch also regulates chewing.
- The ophthalmic branch (V1) is responsible for pain from the scalp, forehead, upper eyelid and tip of the nose.
- The maxillary branch (V2) pain covers the lower eyelid, the side of the nose, the upper lip and cheek, and the upper teeth and gums.
- The mandibular branch (V3) is responsible for pain of the lower teeth and gums, lower lip, chin, jaw, and part of the ear. It is also responsible for supplying the muscles involved with chewing (mastication), those muscles involved with chewing.
Successive recurrences are incapacitating and the dread of provoking an attack may make sufferers unable to engage in normal daily activities.
Because of the variety of treatment options available, having trigeminal neuralgia doesn’t necessarily mean you’re doomed to a life of pain. Interventional pain physician usually can effectively manage trigeminal neuralgia.