New Delhi: Trigeminal Neuralgia (TN), often dubbed the “suicide disease,” is an excruciatingly painful condition affecting the trigeminal nerve, which controls sensation in the face. Recent reports highlight a distressing trend: even very young patients, as young as six years old, are grappling with this debilitating ailment. Dr Pratham Bysani, Senior Consultant Neurosurgeon at Vasavi Hospitals, emphasizes the severity of TN, describing it as one of the most agonizing pain conditions, comparable to, or even surpassing, limb amputation or childbirth.
Extreme pain
The term “suicide disease” reflects the extreme pain associated with TN, which often leads to suicidal thoughts and severe psychological distress. Patients frequently experience pain that spreads across the face and down the neck, triggered by even the slightest touch or breeze. This condition is notoriously difficult to diagnose and is often mistaken for migraines or other facial pain disorders. Trigeminal Neuralgia involves the trigeminal nerve, which branches from the area behind the ear and extends across the face, including the cheeks, jaw, lips, and nose. Pain can be localized to one of the nerve’s branches—upper, medial, or lower—or, in rare cases, affect both sides of the face (bilateral trigeminal neuralgia). The disorder is more prevalent in individuals over the age of 50, with about 150,000 new diagnoses annually in the US, according to the American Association of Neurological Surgeons.
Disrupting daily life
The intense pain of TN can severely disrupt daily life, leading individuals to avoid social interactions and routine activities like eating or talking. Many people with TN have reported losing jobs and experiencing marital difficulties due to the condition’s debilitating nature. Symptoms can vary from brief, severe pain (TN1) to continuous pain (TN2), often accompanied by sensitivity to light and sound, nausea, and vomiting. Episodes of pain may recur with varying frequency and intensity, Dr. Pratham Bysani, Senior Consultant at Vasavi Hospitals, said by adding that diagnosing trigeminal neuralgia involves a process of elimination, as no single test can confirm the condition definitively. Physicians conduct thorough physical and neurological exams and use MRI scans to check for tumors compressing the trigeminal nerve. A response to anti-seizure medications or tricyclic antidepressants may also indicate TN.
Treatment options
Several treatment options are available for managing TN. Medical management includes anticonvulsant medications, such as carbamazepine and gabapentin, which help control nerve firing, and tricyclic antidepressants like amitriptyline for pain relief. For patients who do not find relief from medications, surgical interventions may be necessary. Percutaneous procedures, such as balloon compression, glycerol injections, and radiofrequency ablation, offer temporary relief by damaging the nerve or its insulation. Stereotactic radiosurgery uses targeted radiation to create lesions that block pain signals, while neurectomy involves cutting nerve branches to prevent pain transmission. However, these methods may only provide temporary relief and can lead to recurring pain.
Effective treatment
Microvascular Decompression (MVD) surgery is considered the most effective long-term treatment. This procedure involves opening the skull, identifying the trigeminal nerve, and placing a cushion of Teflon between the nerve and the compressing blood vessel. MVD offers prolonged pain relief with a low risk of permanent facial numbness. Patients typically experience rapid pain relief and a short hospital stay.
Success stories
“Despite its invasive nature, MVD is generally safe, though risks such as infection, hearing loss, facial numbness, and very rare complications like stroke may occur. Success stories, such as a recent patient who had been suffering from TN for six years and is now symptom-free, underscore the potential for significant improvement with appropriate treatment. Understanding and addressing trigeminal neuralgia is crucial for improving the quality of life for those affected by this severe pain condition,” Dr Pratham Bysani said.
Trigeminal Neuralgia is an intensely painful condition affecting the facial nerve, with even children as young as six experiencing its debilitating effects. Let’s explore the treatment options here. Health Conditions Health News: Latest News from Health Care, Mental Health, Weight Loss, Disease, Nutrition, Healthcare
