As the sweltering summer passes and autumn begins, there are people who experience extreme pain even when the wind blows on their face. Even with a small stimulus, you experience pain as if someone is stabbing your face with an awl for at least 10 seconds to 2 minutes, and this pain comes over and over again.
If these symptoms persist, trigeminal neuralgia should be suspected. Trigeminal neuralgia occurs frequently in patients in their 40s and 50s, and the incidence increases with increasing age. Trigeminal neuralgia, which still has a lifetime prevalence of only 0.15% in Korean society, is an unfamiliar disease to people. However, as the elderly population is rapidly increasing due to a rapidly aging society, side effects and social and economic burden problems caused by trigeminal neuralgia among middle-aged and elderly people are gradually coming to the surface.
The number of trigeminal neuralgia patients is increasing with the aging wave of Korean society. According to a report by the Health Insurance Review and Assessment Service, the number of trigeminal neuralgia patients in Korea increased from 56,788 in 2013 to 64,426 in 2016, and most of the patients were middle-aged women in their 50s or older.
strange but scary ‘trigeminal neuralgia’, explained in detail by Hwan-Bo Jeong, a consultant in the pain medicine department of Hidak.
What is trigeminal neuralgia? Causes of trigeminal neuralgia
In our head, 12 cranial nerves emerge directly from the brain. The fifth cranial nerve is called the trigeminal nerve. The trigeminal nerve is divided into three branches and is responsible for sensation and movement in our face.
Trigeminal neuralgia occurs when the trigeminal nerve, which plays an important role in our face, is stimulated by blood vessels. In most cases, trigeminal neuralgia is caused by an artery location abnormality. Or, rarely, it can be caused by a brain tumor, cerebral aneurysm, or multiple sclerosis.
Symptoms of trigeminal neuralgia
The repetitive beating of the arteries overstimulates the nerves, causing short, sudden, sharp, sharp pains in the lower part of the face. In many cases, pain is felt even when certain areas of the face are irritated by touching, chewing gum, or brushing teeth.
Pain is felt mainly in the cheeks and jaw, which is mainly controlled by the trigeminal nerve. Because the trigeminal nerve is separate on the right/left side, the pain only occurs on one side of the face. The pain can last from a few seconds to up to two minutes and can occur up to 100 times a day.
Main age of patients with trigeminal neuralgia
The majority of people with trigeminal neuralgia are middle-aged and elderly. It is also a disease that affects more women than men. However, young people can also complain of trigeminal neuralgia, which is mainly caused by nerve damage caused by multiple sclerosis, an autoimmune disease.
Treatment and prevention of trigeminal neuralgia
It is important to determine the exact cause of trigeminal neuralgia. More than 90% of trigeminal neuralgia is caused by arterial stimulation, but less than 10% are caused by brain tumors or cerebral aneurysms. If it is caused by a brain tumor or brain aneurysm, treatment of the underlying disease dramatically improves trigeminal neuralgia.
Most trigeminal neuralgia cannot be prevented, and when trigeminal neuralgia occurs, drug treatment takes precedence. An antiseizure agent that stabilizes the nerve membrane of the stimulated trigeminal nerve is used as a first-line treatment. In particular, you can try a drug called carbamazepine, and if it doesn’t work, you can change to gabapentin or phenytoin. Baclofen and tricyclic antidepressants may also be tried.
However, if repetitive and intolerable pain persists, making daily life difficult‘surgical treatment’can be considered. Pain can be relieved by surgery to separate the trigeminal nerve from the artery that continuously stimulates the nerve, but the pain recurs in 15% of patients after surgery.
Help = Hwan-Bo Jeong, Consulting Doctor at Hidak (Pain Medicine Specialist)
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