Trigeminal neuralgia
(TN) is a disorder of unilateral (usually
right-sided) facial pain. While the exact cause is
unknown, it is thought that TN results from
irritation of the trigeminal nerve. This irritation
results from damage due either to changes in the
blood vessels or the presence of a tumor or other
lesions that cause compression of the nerve.
The
first symptoms of TN most commonly occur in persons
over the age of 50, and affect women more often than
men.
The pain of TN is characterized by
unilateral pain attacks that start abruptly and last
for varying periods of time from minutes to hours.
The pain quality is usually sharp, stabbing,
lancinating (cutting or tearing), and burning. It
may have an "electric shock"-like
character. The attacks are initiated by stimuli such
as light touch of the skin, chewing, washing the
face, and brushing the teeth. In some individuals
the attacks may be initiated by non-painful physical
stimulation of specific areas (trigger points or
zones) that are located on the same side of the face
as the pain.
Medical treatment is often
very effective in controlling pain symptoms. In
fact, the anti-seizure drug carbamazepine is so
effective initially that the lack of response often
calls into question the accuracy of the diagnosis.
For
persons with continued pain after medical therapy,
surgical options may be considered. These procedures
have variable risks but may be very effective.
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