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Trigeminal Neuralgia

Introduction

Trigeminal neuralgia is a neurological disorder characterized by intense, stabbing facial pain. From a patient's perspective, it's more than just pain—it's a relentless assault on daily life, impacting everything from eating to social interactions.

Symptoms

Patients experience sudden, severe facial pain, often described as electric shocks or stabbing sensations. This pain can be triggered by routine activities such as eating, talking, or even a gentle touch. The pain is typically localized to one side of the face and can last from a few seconds to minutes, but the intensity can be excruciating.

What causes your pain?

In 95% of the cases the cause of Trigeminal neuralgia is often not found. In some cases, it can also be associated with conditions like multiple sclerosis or nerve damage.

How do we diagnose?

Diagnosing trigeminal neuralgia involves a thorough medical history and neurological examination. Imaging studies such as MRI may be performed to rule out other causes of facial pain and to identify any compressions of the trigeminal nerve.

Differential Diagnosis:

Distinguishing trigeminal neuralgia from other causes of facial pain is crucial. Conditions such as dental problems, temporomandibular joint disorders, and cluster headaches can mimic trigeminal neuralgia but require different treatment approaches.

Classification

Trigeminal neuralgia is classified into two types: typical and atypical. Typical trigeminal neuralgia is characterized by sudden, severe attacks of pain, while atypical trigeminal neuralgia involves a constant, dull ache with occasional sharp pain episodes.

How do we treat?

Treatment options for trigeminal neuralgia range from medications to surgical interventions. For some patients, medications like anticonvulsants can provide relief. However, when medications are ineffective or cause intolerable side effects, interventional procedures may be considered.

Gasserian Ganglion Radiofrequency Ablation (RFA):

Gasserian ganglion RFA is an interventional procedure performed by a pain physician. It involves using heat generated by radiofrequency waves to disrupt the function of the Gasserian ganglion, which is involved in transmitting pain signals from the face to the brain. By targeting this area, the goal is to interrupt the pain signals, providing relief from trigeminal neuralgia. While the procedure may involve some discomfort and risks, many patients are willing to undergo it in the hope of significant pain reduction or long-term relief.