Trigeminal neuralgia: More than just "face pain"

Author: Zhu Chunwei Guangdong Provincial People's Hospital Zhuhai Hospital

Reviewer: Bao Hong, Chief Physician, Zhuhai Branch of Guangdong Provincial People's Hospital

Among the complicated neurological diseases, there is a kind of pain that often makes patients miserable with its unique disguise, and that is "trigeminal neuralgia". With its unique "mask" and indescribable pain, trigeminal neuralgia has quietly become an indelible shadow in the lives of many patients. It is not just a "face pain", but also a complex and changeable health challenge, which often makes patients mistakenly think it is toothache, migraine or other common pain, thus delaying the best time for treatment. Today, we will analyze this "mysterious and annoying" disease, understand its symptoms, causes, diagnosis methods and treatment strategies, to help patients better understand and effectively deal with this disease.

1. Unveiling the “mystery” of trigeminal neuralgia

Trigeminal neuralgia, as the name suggests, is severe pain originating from the trigeminal nerve. The trigeminal nerve (the fifth pair of cranial nerves) is one of the twelve pairs of cranial nerves in the human body, which is mainly responsible for the transmission of facial sensations and some motor functions, including three branches: the ophthalmic nerve, the maxillary nerve, and the mandibular nerve. When this important nerve is abnormally stimulated or compressed, we will feel an unbearable pain, as violent as an electric shock, which instantly penetrates the entire face or head.

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This pain is not only extremely intense, but also camouflaged. Not only can it disguise itself as severe toothache, making people mistakenly think it is caused by caries or gingivitis, but it can also cleverly disguise itself as nose pain or eye pain, especially when specific "trigger points" are touched or stimulated. The pain may suddenly occur and last from a few seconds to a few minutes, making it unpredictable and unbearable. What is even more troubling is that the camouflage of trigeminal neuralgia is also reflected in the changes in its course. In the early stages, it may only occur occasionally, but over time, the pain may become more frequent and severe, seriously affecting the patient's quality of life. Therefore, for trigeminal neuralgia, we must not only pay attention to its typical pain characteristics, but also be alert to its changeable camouflage to avoid delays in diagnosis and treatment.

2. Exploring the cause of trigeminal neuralgia

The causes of trigeminal neuralgia are complex and varied, including two major categories: primary and secondary. The cause of primary trigeminal neuralgia is often difficult to determine, and may be related to abnormal excitement or increased sensitivity of the nervous system. Secondary trigeminal neuralgia is mostly caused by other diseases, such as multiple sclerosis, skull compression, and cerebrovascular disease. These diseases affect the normal physiological function of the trigeminal nerve directly or indirectly, thereby triggering pain.

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3. Diagnosis: Accurate positioning and scientific analysis

Trigeminal neuralgia can be easily confused with diseases such as toothache, so its diagnosis needs to be extremely cautious. The doctor needs to inquire about the patient's medical history in detail, conduct a comprehensive neurological examination, and may use imaging techniques (such as MRI, CT) to assist in the diagnosis. According to the specific characteristics of the pain and the frequency of attacks, trigeminal neuralgia can be divided into typical and atypical categories. Typical trigeminal neuralgia is characterized by paroxysmal severe pain on one side of the face, and the pain area clearly corresponds to a branch of the trigeminal nerve. Atypical trigeminal neuralgia may manifest as persistent pain or be accompanied by other complex neurological symptoms.

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IV. Treatment: Multi-pronged approach and comprehensive measures

The current main treatment for trigeminal neuralgia is a combination of drug therapy, surgical intervention and non-drug therapy.

1. Drug treatment: After trigeminal neuralgia occurs, drug treatment is generally the first choice. Commonly used drugs include carbamazepine: This is one of the most commonly used drugs for the treatment of trigeminal neuralgia. It can effectively relieve pain for most patients, but it is important to start with a small dose. If the effect is not good, the dose can be increased under the guidance of a doctor. However, although drug treatment can relieve symptoms, it is often difficult to cure the disease.

2. Surgical intervention: For patients who are not well treated with medication or whose condition is serious, surgical intervention becomes an important treatment method. Among them, microvascular decompression surgery has become a more common surgical method because it can relieve the compression of the trigeminal nerve by blood vessels and fundamentally eliminate the source of pain. In addition, there are also minimally invasive treatment methods such as radiofrequency target thermocoagulation and balloon compression.

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3. Non-drug therapy: Non-drug therapy includes neuromodulation, physical therapy and psychological support. Neuromodulation techniques, such as transcutaneous electrical stimulation and transcranial magnetic stimulation, can relieve pain by regulating the functional state of the nervous system; physical therapy, including acupuncture and massage, can help relax muscles and relieve tension; and the professional support of psychologists and personalized rehabilitation plans can build a psychological defense line for patients to actively cope with pain and emotional stress.

5. The road to recovery: balanced diet and optimistic attitude

In the recovery process of trigeminal neuralgia, a balanced diet plays an important role. Patients should consume more high-protein, easily digestible liquid food to replenish the energy and nutrition needed by the body; at the same time, foods rich in B vitamins are also indispensable because they help promote nerve recovery. In addition, patients should also avoid eating fried foods, seafood, nuts and other foods that may induce pain, so as not to aggravate the condition.

In addition to careful dietary adjustments, maintaining an optimistic attitude is also a key factor in recovery. Although trigeminal neuralgia is extremely painful, it is entirely possible to overcome this "disguised" pain with professional treatment and strong will. Patients can share their feelings and needs with family and friends, and seek their support and understanding; at the same time, they can also exchange ideas and share experiences with fellow sufferers.

In summary, trigeminal neuralgia, a severe pain that is good at disguising itself, is far from being simply described as "pain in the face". Its symptoms vary, bringing not only physical torture to patients, but also mental torment. However, as long as we face it bravely, actively treat it, and rehabilitate it scientifically, we will be able to overcome it and regain the joy of life.