Question

(I’m looking for names of potential damaging areas and what the patient will encounter. Tell me in real life situations what this patient might experience)

A patient has just been diagnosed with Trigeminal Neuralgia, tell the patient what they might experience for the rest of their life if they do not receive treatment.

Answer 1

Trigeminal neuralgia is one of the most excruciating pain known to humanity. The pain is usually experienced in lower face and jaw. Sometimes around the nose and above eyes.

Trigeminal nerve is the fifth of the 12 cranial nerves which provides sensations to face. The irritation of this nerve is what causes the pain. There are several possibilities for the irritation like contact of healthy artery or vein with the nerve which creates pressure as the nerve enters the brain or a tumor near the nerve which may put pressure on the nerve or even MS (multiple sclerosis) which damages myelin sheath.

The pain will be stabbing and electric shock like. Usually it begins spontaneously out of nowhere. Sometimes external factors like a dental surgery, a blow on face, or an accident involving face my also trigger pain. It is often experienced in upper or lower jaw and is often confused for a dental abscess.

The pain is defined as type l (classic) and type ll (atypical). Type l pain has a definite period of remission. The pain will be sharp, throbbing, and shock-like. It is triggered usually by touching or by specific activities.

Type-ll pain is constant with burning sensation and is more wide spread (area of face). There may be no remission period but the symptoms are difficult to treat.

The pain may occur in cycles with peak attack followed by weeks, months, or even years of no pain. But usually attacks intensifies overtime followed by shorter pain-free periods.

Some have less than one attack per day while others have more than a dozen attack in an hour.

The pain begins with a sensation of electric shock that intensifies to form strong stabbing pain within less than 20 seconds. The pain often leaves the patient with uncontrollable facial twitching which is why it is also called tic douloureux.

Though there is no specific treatment for the disease as such, pain medications and anticonvulsive medication are administered to alleviate pain symptoms. Surgery is prescribed to patients who have no improvement with medications.