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What is Trigeminal Neuralgia?

Trigeminal neuralgia is a sudden, severe facial pain. It usually occurs in sudden short attacks lasting from a few seconds to about two minutes, which stop just as abruptly.
In the vast majority of cases it affects part or all of one side of the face, with the pain most commonly felt in the lower part of the face. Very occasionally it affects both sides of the face, but not normally at the same time.

What causes trigeminal neuralgia?

In the vast majority of cases, trigeminal neuralgia is caused by compression of the trigeminal nerve. This is the largest nerve inside the skull, which transmits sensations of pain and touch from your face, teeth and mouth to your brain.
This compression is usually caused by a nearby blood vessel pressing on part of the nerve inside the skull.
In rare cases, trigeminal neuralgia can occur as a result of damage to the trigeminal nerve, caused by an underlying condition such as multiple sclerosis (MS) or a tumour.

How trigeminal neuralgia is treated?

Medications

To treat trigeminal neuralgia, your doctor usually will prescribe medications to lessen or block the pain signals sent to your brain. If the medication is ineffective or causes too many side effects, you may be referred to a specialist to discuss surgical procedures that may help.

Surgery

Your specialist may recommend having surgery to open up your skull and move away any blood vessels compressing or damage the trigeminal nerve to keep it from malfunctioning. Research suggests this operation offers the best results in terms of long-term pain relief.
Surgical options for trigeminal neuralgia include:
Microvascular decompression. This procedure involves relocating or removing blood vessels that are in contact with the trigeminal root. During microvascular decompression, your doctor makes an incision behind the ear on the side of your pain. Then, through a small hole in your skull, your surgeon moves any arteries that are in contact with the trigeminal nerve away from the nerve, and places a pad between the nerve and the arteries.
Gamma Knife radiosurgery. In this procedure, a surgeon directs a focused dose of radiation to the root of your trigeminal nerve. This procedure uses radiation to damage the trigeminal nerve and reduce or eliminate pain.

References

http://www.nhs.uk/Conditions/Trigeminal-neuralgia/Pages/Introduction.aspx
http://www.mayoclinic.org/diseases-conditions/trigeminal-neuralgia/basics/treatment/con-20043802

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