Some say childbirth is “the most painful thing in the world,” but some doctors point out that the pain of trigeminal neuralgia is comparable to childbirth — and it recurs persistently, disrupting patients’ lives and even leading to depression. A specialist in pain medicine advises that the public should increase their awareness of trigeminal neuralgia, and once symptoms appear, they should seek medical attention and take medication to relieve the pain.
Annie is a “strong” woman who often jokes that she has never been afraid of pain. In the past, she insisted on natural childbirth and gave birth to three children. However, at the beginning of this year, she began to develop a fear of “pain,” because she discovered that the left side of her face frequently ached, with the pain being especially noticeable when chewing. She suspected it was caused by tooth decay, so she asked her dentist to extract the aching teeth to reduce the pain.
Patients Mistakenly Extract Teeth for Toothache
Unfortunately, even after having four teeth extracted, Annie’s pain persisted. What’s more, every morning and evening when she washed her face, the slightest touch to her cheek would make her cry out in pain. To avoid unnecessary contact, Annie eventually wrapped her head in a silk scarf. Seeing this, her husband realized the situation was not simple, and only then was it discovered that she was suffering from trigeminal neuralgia!
Pain Like Being Cut by a Knife or Struck by Lightning — Hard for Patients to Bear
The trigeminal nerve refers to the fifth pair of cranial nerves, which mainly govern sensation in three different areas: the forehead, the cheeks, and the jaw. Trigeminal neuralgia refers to pain in these three areas. “Any movement that touches the facial expressions can trigger pain — something as simple as shaving, brushing teeth, eating, drinking water, or even a gentle breeze blowing across the cheek can trigger trigeminal neuralgia. Many people describe the pain as being cut by a knife or struck by lightning. Each attack lasts only a few seconds to a few minutes, and it may occur dozens of times or more a day.”
To this day, the cause of trigeminal neuralgia remains unknown. Dr. Lee Yuk-ming points out that it is estimated that the cranial nerve may be too close to a blood vessel, causing part of the nerve to be compressed. In addition, similar symptoms may be caused by brain tumors or multiple sclerosis. People of all ages and genders can develop the condition, with those aged 50 to 60 being more commonly affected.
Neuropathic-Pain Medication Is the First-Line Treatment
It can be seen that trigeminal neuralgia has no identifiable cause and is difficult to prevent. Although the condition does not trigger other facial nerve problems, over time it will inevitably have a huge impact on patients’ lives, work, and emotions. Dr. Lee says that using medication to treat trigeminal neuralgia is the mainstream approach. The most common method is taking neuropathic-pain medications to lower the sensitivity of the trigeminal nerve and reduce muscle tension, thereby reducing the frequency of pain attacks.
“At present, medication is the first choice for treating trigeminal neuralgia. Neuropathic-pain drugs such as carbamazepine, amitriptyline, and pregabalin can help reduce the sensitivity of the trigeminal nerve to pain. These drugs for trigeminal neuralgia can be used alone or in combination. Generally, patients can see results one to two weeks after starting medication.” As for ordinary analgesics, they cannot eliminate this type of pain; patients who randomly take painkillers may actually delay their condition, or even cause unnecessary stomach discomfort or the risk of stomach bleeding.
Dr. Lee Yuk-ming adds that when medication proves unsatisfactory, patients may consider interventional treatment or surgery. Surgical treatment includes opening the skull to separate the blood vessel from the nerve. Interventional treatment uses a radiofrequency needle to destroy the nerve’s ability to transmit pain. After interventional treatment or surgery, most cases improve greatly, and many patients can stop taking medication.
Source: Metro Daily, 14/1/2016
Information provided by Dr. Lee Yuk-ming, Specialist in Pain Medicine
