Trigeminal Neuralgia (Facial Nerve Pain) (cont.)
What Causes Trigeminal Neuralgia?
- The condition has no clear-cut cause.
- Some experts argue that the syndrome is caused by traumatic damage to the nerve as it passes from the openings in the skull to the muscles and tissue of the face. The damage compresses the nerve, causing the nerve cell to shed the protective and conductive coating (demyelination).
- Others believe the cause stems from biochemical change in the nerve tissue itself.
- A more recent notion is that an abnormal blood vessel compresses the nerve as it exits from the brain itself.
- In all cases, though, an excessive burst of nervous activity from a damaged nerve causes the painful attacks.
What Are the Symptoms of Trigeminal Neuralgia?
- A defining feature of trigeminal neuralgia is the trigger zone-a small area in the central part of the face, usually on a cheek, nose, or lip, that, when stimulated, triggers a typical burst of pain.
- A light touch or vibration is the most effective trigger.
- Because of this, many common daily activities trigger the attacks.
- Washing your face, brushing your teeth, shaving, or talking
- Common sensations such as having wind hit your face
- Eating and chewing
- Many people avoid food and drink rather than experience the severe pain.
- These people risk weight loss and dehydration, a leading cause of hospitalization in this group.
- People frequently require hospitalization for rapid pain control when their trigeminal neuralgia becomes unmanageable at home.
- Between attacks, most people remain relatively pain-free. A subgroup, however, experience a dull ache between attacks, suggesting physical compression of the affected nerve, either by a blood vessel or some other structure.
When Should I Call the Doctor About Trigeminal Neuralgia?
Contact your doctor when you begin to have these pains.
- It is essential you see a doctor familiar with the care of patients with trigeminal neuralgia early on to help prevent the development of more severe complications.
- It is especially important to work with your doctor because with appropriate drug therapy trigeminal neuralgia can almost always be controlled.
Seek immediate medical attention or go to a hospital's Emergency Department under the following circumstances:
- When your current medication does not control the pain and you need immediate relief
- When your pain prevents eating and drinking and places you at risk for malnutrition or dehydration
- When you experience profound side effects of your medication such as severe drowsiness, sedation, nausea, or vomiting
- When a doctor advises you to seek evaluation and treatment for any of these problems
Last Reviewed 11/21/2017
Scott H Plantz, MD, FAAEM
Francisco Talavera, PharmD, PhD
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