What is Trigeminal Neuralgia?
Trigeminal Neuralgia is a pain condition that involves the three branches of the trigeminal Nerve. The trigeminal nerve primarily carries sensory information between the face and scalp, and brain. Sufferers often describe a shock-like, stabbing or shooting pain on one side of their face. This pain can last anywhere between half a second and a few minutes. These attacks can happen once per day or up to 50 times per day. Sometimes, sufferers may describe tearing or redness in their eyes, on the same side as their pain .
Trigeminal Neuralgia sufferers are often hypersensitive to things such as; brushing teeth, chewing, light touch around the face or even speaking. These types of activities can often lead to an attack for these people. Women are more likely to experience Trigeminal Neuralgia than men, and it is most likely to happen in people aged 50 years or older.
Anatomy of the Trigeminal Nerve
There are 3 branches of the Trigeminal Nerve. The Opthalmic Branch (V1) innervates the area around your eyes, nose and from the top of your forehead, into your scalp. The Maxillary branch (V2), innervates the area from your temple, down to your cheeks and upper lip. The mandibular branch (V3), innervates the remainder of your temple and jaw, but is also associated with the muscles involved with chewing [2, 1].
Types of Trigeminal Neuralgia
1. Classical Trigeminal Neuralgia
This is when the only cause of Trigeminal neuralgia is due to neurovascular compression. This often happens due to damage of a nerve, around the nerves root from the brainstem, because of compression by an artery or vein. Further; ‘Primary Paroxysmal’ Classical Trigeminal Neuralgia, indicates that the sufferer has pain free periods. Whereas, Concomitant Continuous pain, suggests that the sufferer experiences mild pain between attacks .
2. Secondary Trigeminal Neuralgia
When an underlying disease causes Trigeminal Neuralgia, it is classified as Secondary Trigeminal Neuralgia. This might be from, Multiple Sclerosis, tumour or arteriovenous malformation .
3. Idiopathic Trigeminal Neuralgia
Idiopathic Trigeminal Neuralgia is when a sufferer experiences the symptoms of Trigeminal Neuralgia, but there is no apparent cause found on investigation. This can suggest pathology or sensitivity of the brainstem may be involved .
As with Classical Trigeminal Neuralgia, it can be classified as ‘Purely paroxysmal’ or “Concomitant Continuous Pain”. Approximately half of all Trigeminal Neuralgia Patients experience continuous pain.
Trigeminal Neuralgia is commonly not diagnosed, or misdiagnosed, for long periods of time due to the similarity in its symptoms from those of migraine and cluster headaches.
What is the cause of Trigeminal Neuralgia?
As mentioned above, there are quite a few different causes of Trigeminal Neuralgia, especially with Secondary Trigeminal Neuralgia. What we see commonly in our patients who suffer from Trigeminal Neuralgia, is a sensitised brainstem and dysfunction in the cervical spine where it is located .
This sensitised brainstem perceives otherwise non-threating stimulus (such as chewing or brushing your teeth) and reacts as if it were a threat. The brainstems reaction to this threat is to cause pain along the area that the Trigeminal Nerves innervate. This is how sufferers of Trigeminal Neuralgia can experience attacks so frequently, with seemingly innocuous triggers.
I’ve tried it all, What else can be done to help Trigeminal Neuralgia?
Many of our patients who suffer from Trigeminal Neuralgia have tried many different therapies, including; strong pain-killers, anti-convulsant medication, Botox Injections or even surgery. These may have had some short-term or mild benefit, but the pain always returned. This is where the Headache and Migraine Clinic can help, we are trained to specifically assess your cervical spine and the sensitivity of your brainstem, to see if they are the true cause of your Trigeminal Neuralgia. If that’s the case, then we can start treatment immediately, to cure the cause of your pain and not just cover up the symptoms.
Treatment will be addressing the dysfunction in your cervical spine, and then will aim to de-sensitise your brainstem with our world-leading manual techniques. Once treatment has started, we expect to see rapid results within the first 6 sessions, as we do with 85-90% of our patients. The best bit is that it is gentle, safe, non-invasive and medication-free.