Trigeminal Neuralgia & Other Facial Pains
beware
Not Every Pain Disorder in the Face is Trigeminal Neuralgia...
Did you know that Trigeminal Neuralgia (TN) is really rare?
It occurs in less than 0.3% of the general population.
Unfortunately, many facial pains are inappropriately diagnosed as Trigeminal Neuralgia.
What Is Trigeminal Neuralgia?
Classic/Primary Trigeminal Neuralgia (TN)
Evidence of Trigeminal Nerve compression with the following symptoms:
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Brief (less than 1 sec and up to 2 min), severe, electric shock-like, stabbing, shooting or sharp pain typically triggered by a non-painful stimulus such as light touch
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A refractory period (no pain can be triggered in the same area) after a painful attack is typically present
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Painful areas and trigger zones are located within the 3 branches of the Trigeminal Nerve
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Pain is typically only one one side of the face
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Typically no pain is present in between painful attacks
What Causes Primary or Idiopathic Trigeminal Neuralgia?
No one knows.
Imaging such as MRI is valuable in ruling out tumors or diseases such as multiple sclerosis, which can cause Secondary TN. However, no one truly knows what causes Classic/Primary/Idiopathic TN but there are some theories. For Classic/Primary TN, one theory is that the Trigeminal Nerve is being compressed by pulsations from neighboring blood vessels. But that doesn't explain why Idiopathic TN patients experience the same set of symptoms with no evidence of Trigeminal Nerve compression. Another theory, that Dr. Wang believes might be closer to an accurate answer, takes more of a holistic and integrative approach to explaining the possible cause of TN, taking into account the possibility of a combination of factors such as exposure to: viral illnesses, local injury (even something as minor as repeated local anesthetic injections or a long-standing cavity), and other factors like chronic stress. The conclusion is that at this time, no one can say for certain how or why TN develops.
Conventional Trigeminal Neuralgia Treatment Options
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TN diagnosis is typically confirmed by a neurologist based upon symptoms and imaging results. Once diagnosed, the current standard for treating TN is to start by prescribing medications, followed by more invasive procedures if there is evidence of Trigeminal Nerve compression. Unfortunately, the medications are often not well tolerated long-term due to severe side effects and the surgical procedures are invasive and are not always successful.
Medication
Carbamazepine
Oxcarbazepine
Surgery
Microvascular decompression
Brain stereotactic radiosurgery (GammaKnife)
Rhizotomy
Our Therapeutic Approach
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The most important first step to treating facial pain is to make an accurate diagnosis. The diagnosis will determine the appropriate path of treatment. For example, if facial pain is coming from the muscles, then prescribing carbamazepine would not be appropriate.
Once a TN or ATN diagnosis has been confirmed, Dr. Wang offers a safe, non-invasive alternative to the conventional therapies listed above. The Sphenopalatine Ganglion (SPG) block has been well studied and effectively used to provide pain relief for patients with TN and Atypical Facial Pains. Click on the link below to learn more about this exciting innovative therapy.
Contact our office to schedule an evaluation today.
Have you been diagnosed with TN or are you experiencing unexplained facial pains?
Call us today to get some answers and relief: 773.873.6372