Trigeminal neuralgia
Trigeminal neuralgia is a chronic pain condition affecting the facial trigeminal nerve. This nerve sends sensation impulses from the face, teeth, and mouth to the brain. When it becomes irritated or inflamed, it can send sharp, painful impulses to one side of the face. These typically last between seconds and minutes.
Symptoms can be triggered by very light touches of your face; for example, brushing your teeth or chewing food.
A flare-up of trigeminal neuralgia usually lasts several days or weeks to months, and then you may recover. It may subside for good or come back after months or even years.
Compression of the trigeminal nerve leads to these symptoms and is commonly caused by a blood vessel that impinges on the nerve. Much less commonly, it can be caused by a tumor or associated with other neurological conditions like multiple sclerosis.
Trigeminal neuralgia is uncommon - about 1 person in 10,000 develops it each year. It mainly affects older people, and it usually starts in your 60s or 70s, but is rare in younger people. Women are more commonly affected than men.
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How can it be treated?
Distracting yourself from the pain to reduce the intensity can help, and ensuring that you add relaxation methods into your everyday routine can help in the long-term, as it reduces the prominence pain has in your life and therefore stops it from snowballing.
A medication called carbamazepine can be used in the treatment of trigeminal neuralgia. This is an anticonvulsant medication typically used to treat epilepsy. It reduces nerve pain by slowing down the sensation response in the nerves. It is common to take carbamazepine until about a month after the pains have stopped when the dose may then be reduced gradually and stopped. Following this, there is often a period of being pain free, but for many people with trigeminal neuralgia the pain returns, and treatment needs to be restarted. There are other nerve pain medications available. However, most of these are not suitable for trigeminal neuralgia. Some people find that carbamazepine works well at first but less well over the years.
Some minor and major surgical options can relieve this pain, but this would need further discussion with a specialist.
Am I fit for work?
You should be fit for work with trigeminal neuralgia.
When should I see my doctor?
We recommend seeing your doctor if the pain persists or increases in intensity, and conventional painkillers such as acetaminophen or ibuprofen have not helped.
They will usually begin by examining the nerves in your face. It may take some time for your doctor to identify the cause of your symptoms as there is no single investigation that can diagnose the condition. You may also be asked to come back for further evaluations to rule out other causes for your symptoms. The doctor may also recommend that you see a dentist to ensure no problems with your mouth that may be causing your symptoms.
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