TRIGEMINAL NEURALGIA
Tic douloureux is another name for trigeminal neuralgia (TN).
It is a very frequent neuropathic condition characterized by abrupt, severe episodes of
electric or lancinating pain along the cranial nerve V (CN V) distribution.
TN is still one of the most common causes of facial pain in the world.
Women experience it marginally more frequently than men do.
Although few cases have been observed in childhood, TN often manifests itself after the fifth
decade of life.
PATHOPHYSIOLOGY :-
In recent years there has been significant progress in our understanding of the pathogenesis
of TN. This disease is divided into two major categories due to the reason for the cause, but
in both categories the type of disease is the reduction of the trigeminal nerve. Degeneration
refers to the destruction of the protective protective coating (myelin) on the outside of
neurons. Without myelin, nerve conduction is impaired, hearing, movement, etc. In classic
TN, blood vessels impinge on the trigeminal nerve, producing regional demyelination. Thus,
arteriolar stiffening that occurs with aging is more evident in increased TN after age 50.
This compression-induced reduction is also seen in secondary forms of TN caused by
tumors. In addition, there is evidence of multiple sclerosis, another common secondary
etiology, neuronal demyelination, providing further evidence that this mechanism plays an
important role in the pathogenesis of TN. The association between demyelination of the
trigeminal nerve and persistent pain attacks indicates that this disease affects the various
functions of the fifth cranial nerve. As mentioned above, the trigeminal nerve carries tactile,
pain, and motor fibers involving parts of the face. Affected nerve fibers have large diameters
and a large amount of myelin around them, while pain fibers are smaller in diameter and
have less myelin around their boundaries. When a contraction occurs, the trigeminal nerve
and pain nerves are connected to each other, electrically connected and weakened. tactile,
means Crosstalk between nerve fibers. . The presence of ephaptic transmission
demonstrates that even small movements of the patient's face can trigger episodes of pain.
SYMPTOMS :-
•Occasional twinges of mild pain
• Episodes of severe, shooting or jabbing pain that may feel like an electric shock
• Spontaneous attacks of pain or attacks triggered by things such as touching the face,
chewing, speaking and brushing teeth
• Bouts of pain lasting from a few seconds to several seconds
• Episodes of several attacks lasting days, weeks, months or longer — some people have
periods when they experience no pain
• Pain in areas supplied by the trigeminal nerve, including the cheek, jaw, teeth, gums, lips,
or less often the eye and forehead
• Pain affecting one side of your face at a time
• Pain focused in one spot or spread in a wider pattern
• Attacks becoming more frequent and intense over time.
Triggers :-
A variety of triggers may set off the pain of trigeminal neuralgia, including:
•Shaving
•Stroking your face
•Eating
•Drinking
