Trigeminal neuralgia is a disorder of the trigeminal nerve that causes episodes of intense pain in the eyes, lips, nose, scalp, forehead, and/or jaw. Trigeminal neuralgia is considered by many to be among the most painful of conditions.
To describe the pain sensation, people describe a trigger area on the face, so sensitive that touching or even air currents can trigger an episode of pain. It affects lifestyle as it can be triggered by common activities in a persons daily life, such as toothbrushing. Breezes, whether cold or warm, wintry weather or even light touching such as a kiss can set off an attack. Although trigeminal neuralgia is not fatal, successive recurrences may be incapacitating, and the fear of provoking an attack may make sufferers reluctant to engage in normal activities.
In some cases of atypical trigeminal neuralgia, the sufferer experiences a severe, relentless underlying pain similar to a migraine in addition to the stabbing pains. In other cases, the pain is stabbing and intense, but may feel like burning or prickling, rather than a shock. Sometimes, the pain is a combination of shock-like sensations, migraine-like pain, and burning or prickling pain. It can also feel as if a boring piercing pain is unrelenting.
Trigeminal Neuropathic Pain
This is a pain condition that happens after an injury to one or more branches of the trigeminal nerve. Trigeminal neuropathic pain is as a result of nerve injury following dental procedures (tooth extractions, root canals, etc), facial fractures, nerve injury from sinus surgery, etc. This condition is often diagnosed as trigeminal neuralgia. This pain is usually continuous and generally is of a burning quality. Many patients with TNP have documented loss of sensation on the face or forehead. It is important to make this distinction, since the surgical procedures that are effective in trigeminal neuralgia, are almost never helpful for TNP, and not uncommonly can make this condition worse.
Trigeminal neuralgia in Dental Malpractice Cases is usually caused during Root Canal Procedures resulting in an over extension of a file or an overfill beyond the apex of the root.
Treatments for trigeminal neuralgia include medication and five different procedures Microvascular decompression, radiofrequency rhizotomy, glycerol rhizotomy, balloon rhizotomy, and stereotactic radiosurgery. Atypical trigeminal neuralgia can also respond to the same treatments as “classic” trigeminal, though success rates are slightly lower. Medications used for trigeminal neuralgia are usually anti-seizure medicines, in particular “tegretol”, “trileptal”, neurontin” and “lyrica.” If medication is not helping or patients are experiencing side effects from the medication, then a procedure can be considered.
Surgery may be recommended, either to relieve the pressure on the nerve or to selectively damage it in such a way as to disrupt pain signals from getting through to the brain.