A. Trigeminal Neuralgia
Trigeminal neuralgia involves the fifth of the 12 paired nerves emerging directly from the brain, the "trigeminal nerve." It is known for some of the most intense pain one can experience and is very rare in individuals under the age of thirty. It can incapacitate the patient from performing daily activities and even vital functions. Thus, it's crucial to diagnose and treat this severe condition swiftly. However, patients often hop from one physician to another in desperation, falling into despair due to these challenging pain.
The most common cause of trigeminal neuralgia is structural variations and abnormalities in the vascular formations adjacent to the nerve. Additionally, differences in bone structure, benign or malignant masses in the skull can also cause trigeminal neuralgia.
The trigeminal nerve has three branches. The first serves the area around the eyes, the second serves the upper jaw and cheek, and the third serves the lower jaw. The third branch also controls movements of certain chewing muscles. The third and second branches are most commonly affected in trigeminal neuralgia, though multiple branches can be affected simultaneously.
Trigeminal nerve
Pain from trigeminal neuralgia is short-lived (ranging from a few seconds to a couple of minutes) and recurrent, feeling like an electric shock. It is usually found on the outer part of the face. Trigger points that initiate the pain can be found inside the mouth. Consequently, patients avoid touching these areas and refrain from activities like washing their face, brushing their teeth, and even eating.
Trigeminal neuralgia is a lifelong condition. Thus, treatment must be planned over the long term. If medications aren't effective enough or have excessive side effects, two options remain: surgical and interventional methods. For patients over the age of 50, interventional methods are preferred.
Interventional Methods for Trigeminal Neuralgia
Interventional methods for addressing Trigeminal Neuralgia are as follows:
- Radiofrequency Thermocoagulation (RFT) of the Trigeminal nerve
- Injection of glycerol around the Trigeminal nerve
- Compression of the Trigeminal nerve using a balloon
Radiofrequency Thermocoagulation (RFT) of the Trigeminal Nerve
Since the 1960s, radiofrequency thermocoagulation has been developed for the destruction of nerves leading to certain areas of the body. RFT employs radiofrequency energy to generate heat, thereby interrupting nerve transmission. This method disables the nerve fibers transmitting pain for pain management. The current sent at very high frequencies, like 500,000 Hz, resembling radio waves, can cause destruction at a single point without any surrounding damage. Over time, the method has been significantly improved and has become safer.
