Trigeminal Neuralgia: Understanding the Pain and Treatment Options - Dr Jaydev Panchwagh

Trigeminal neuralgia, often referred to as the "Suicide Disease," due to its excruciating pain, has been a source of misery for many sufferers over the years. While various remedies, including unconventional ones like applying red chilli powder or even nerve-cutting have been attempted throughout history, modern medicine offers more advanced treatments. One such promising option is Microvascular Decompression Surgery (MVD).

What is Trigeminal Neuralgia?

Trigeminal neuralgia derives its name from the two trigeminal nerves, one on each side of the face, responsible for transmitting facial and gum sensations to the brain. "Neuralgia" simply means nerve pain. Hence, trigeminal neuralgia signifies intense, one-sided facial and gum pain, which is typically unilateral.

Symptoms and Characteristics

This condition manifests with sudden and excruciating pain attacks that last from a few seconds to several minutes. The pain can originate from various parts of the face, including the gums, teeth, nose, chin, cheek, forehead, eye, and temple, radiating to adjacent areas. Patients describe the pain in various agonizing ways, such as an electric shock, sharp knife-like sensations, pricking needles, or a burning sensation. Trigger points like the upper lip, ala of the nose, and gums can initiate these attacks, often triggered by everyday activities like brushing teeth, washing the face, or talking.

The Severity of Trigeminal Neuralgia

Trigeminal neuralgia is a really painful condition. People who have it say it's the worst pain they can imagine. They compare it to feeling like a thousand knives stabbing their face, or like a super spicy chili exploding, or even like getting struck by lightning. When the pain comes, it's so bad that they can't move, their faces twist up because of the pain, and they might even make loud groaning noises. These painful episodes can make a person's life much harder.

Progression of the Disease

In the beginning, the pain comes and goes and doesn't last very long. But as the disease gets worse, the pain happens more often and gets really bad. At first, there are times when the pain goes away for a little while, but later on, it keeps coming back all the time, and it makes people feel really desperate.

The Underlying Cause

The root cause of trigeminal neuralgia is often the compression of the trigeminal nerve by a blood vessel, usually an artery. This pulsatile compression damages the nerve's myelin, leading to the misfiring of nerve impulses and the severe pain characteristic of this condition. Over time, as blood vessels harden and elongate with age, they tend to compress the nerve more intensely.

Treatment Options

Several treatment options are available, including medications like carbamazepine and gabapentin in the early stages. However, these drugs merely provide temporary relief and do not address the underlying cause. Moreover, high doses of these medications can result in side effects like drowsiness and loss of balance.

Microvascular Decompression Surgery (MVD) has emerged as a highly effective treatment option for trigeminal neuralgia. During MVD, a neurosurgeon carefully dislodges the compressing blood vessel from the trigeminal nerve, using a Teflon sponge to separate the two. This procedure often provides immediate relief from pain and has the potential for long-term cure.

Why Choose MVD?

MVD surgery, when performed by an experienced neurosurgical team, has a remarkable success rate of around 98%. It offers the prospect of long-term pain relief and allows patients to discontinue nerve-numbing medications. While no medical intervention is without risks, the complications associated with MVD are exceedingly rare, making it a viable option for those suffering from this agonizing condition.

The Importance of Specialized Centers

The results of MVD surgery are significantly better when performed by the same surgeon and surgical team who have extensive experience in this procedure. Specialized centers, like our Trigeminal Neuralgia Center, aim to provide education, counselling, diagnosis, and surgical treatment for patients with trigeminal neuralgia. These centers serve as a hub for knowledge sharing, patient support, and continuous improvement in the treatment of this debilitating condition.

Trigeminal neuralgia is a condition characterized by intense, one-sided facial and gum pain. While various remedies and treatments have been attempted over the years, Microvascular Decompression Surgery (MVD) has emerged as a highly effective and potentially curative option. When performed by an experienced surgical team, MVD offers long-term pain relief and allows patients to stop taking nerve-numbing medications. Specialized centers dedicated to the treatment of trigeminal neuralgia play a crucial role in educating patients and improving treatment outcomes.