All about trigeminal neuralgia
What do a punk rock drummer who came to fame in the ’90s, a feminist leader who led the second wave in the ’70s, and a British prime minister who switched parties in the late 19th century have in common?
Maybe more than you’d think, but in this case, what Travis Barker, Gloria Steinem, and William Ewart Gladstone shared is an extremely painful nerve condition: trigeminal neuralgia.
What is trigeminal neuralgia?
Trigeminal neuralgia is a rare and exceedingly painful chronic pain disorder that involves the trigeminal nerve on the side of the face. The nerve runs from the top of the ear and then splits into three branches that run to the eye, the cheek, and the jaw.
The pain from trigeminal neuralgia feels like stabbing or electrical shocks in the face, or more rarely, it can cause a constant burning sensation. It can be triggered by anything from brushing your teeth to chewing food to being exposed to wind or cold air. Even smiling can be painful.
The frequency of episodes can vary from person to person. Some experience them only rarely, while others might have episodes several times a day, sometimes with attacks happening almost back to back.
Trigeminal neuralgia is also referred to as Fothergill disease — after John Fothergill, the English physician who discovered it in 1773.
What causes trigeminal neuralgia?
Trigeminal neuralgia is most commonly caused by an artery compressing the nerve and wearing down the myelin sheath protecting it. It’s estimated between 80 to 90% of all cases are caused by this type of compression. Another 5 to 8% of cases are caused by a brain tumour. Other causes include multiple sclerosis (MS), trauma, or inflammation, and in some very rare cases, there is no clear cause.
Learn more about Michelle Kupé’s electrifying pain from trigeminal neuralgia
Who gets trigeminal neuralgia?
Trigeminal neuralgia is relatively rare, with only 0.16 to 0.3% of all people experiencing the condition. It is most common in people over 50 and affects women more often than men.
People with MS are more likely to get trigeminal neuralgia, with potentially 5% of MS patients experiencing it — about 400 times the rate in the general population.
What is the treatment for trigeminal neuralgia?
The first-line treatment for trigeminal neuralgia is medication, and some of the same medications used for seizures can be effective. In fact, medication can provide partial relief in up to 90% of people.
Nerve block injections, steroids, or other medications might also be used, but the results are temporary, leading to repeat procedures.
Surgical interventions are an option if medication doesn’t work or if the patient has adverse reactions to the medication. A rhizotomy is a minimally invasive type of surgery used for trigeminal neuralgia in which a long needle delivers an electrical current or chemical to intentionally damage the nerve to prevent it from causing pain. It offers immediate relief, but it is also a temporary solution.
The most durable solution is microvascular decompression surgery, during which a small piece of Teflon is inserted between the artery and the nerve to protect the nerve.
At The Ottawa Hospital, we have world-leading neurosurgeons conducting microvascular decompression surgery on patients from Ottawa and beyond. And our researchers are constantly developing new, better treatments for conditions like trigeminal neuralgia. Your support means they have access to the best tools to do their best work every day.
