Trigeminal Neuralgia (TN): A suicidal disease

Trigeminal Neuralgia, also known as "tic douloureux" or the "Suicidal disease," is a chronic pain disorder characterized by sudden, severe facial pain. It affects the trigeminal nerve (fifth cranial nerve), responsible for sensation and nerve signaling in the head and face. TN is a type of neuropathic pain often caused by nerve injury or lesions. It is one of the top 10 most painful conditions.

Symptoms of Trigeminal Neuralgia:

- Sudden, intense pain, typically on one side of the face

- Pain attacks lasting from a few seconds to about two minutes

- Numbness or tingling sensation

- Burning, throbbing, shock-like, or aching pain

- Attacks that can occur regularly for days to weeks, sometimes multiple times a day

Types of Trigeminal Neuralgia:

1. Type 1: The typical form with extreme, intermittent, sudden burning or shock-like facial pain, often triggered by activities like shaving, eating, or exposure to wind.

2. Type 2: An "atypical" form characterized by constant aching, burning, stabbing pain, usually less severe than Type 1.

Diagnosing Trigeminal Neuralgia:

Diagnosis is based on medical history, symptom description, and physical and neurological examinations.

Treating Trigeminal Neuralgia:

- Anticonvulsant Medications: Used to block nerve firing, usually effective in TN1 but less so in TN2.

- Antidepressants: Tricyclic antidepressants are sometimes prescribed.

Complementary Treatments for TN:

Some people combine complementary treatments with medication:

- Low-impact exercise

- Yoga

- Creative visualization

- Aromatherapy

- Meditation

- Acupuncture

- Chiropractic treatment of the upper cervical spine

- Biofeedback

- Vitamin therapy

- Nutritional therapy

- Injections of botulinum toxin to block sensory nerve activity

Surgical Options:

Surgery is considered when medication fails or leads to intolerable side effects, such as cognitive disturbances or memory loss. Several rhizotomy techniques are available:

1. Balloon Compression

2. Glycerol Injection

3. Radio Frequency Thermal Lesioning

4. Microvascular Decompression

Each of these surgical approaches aims to alleviate the severe pain associated with TN. It's important for patients to consult with a healthcare provider to determine the most suitable treatment plan based on their specific condition and needs.

Source: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE