परिभाषा

Trigeminal neuralgia (TN) is a disorder of the trigeminal nerve (fifth cranial nerve) that causes severe, shooting pain along one side of the face. The trigeminal nerve senses touch, pain, pressure, and temperature. It also helps make saliva and tears.

चेहरे की नसो मे दर्द

In TN, pain usually lasts for less than a second to a few seconds and may come and go for days, weeks, months, or years. It may go into remission or stop completely for months or years. Over time, though, the attacks may become more frequent and more severe. Attacks can be brought on by chewing, washing, shaving, touching, or even a breeze on the face.

का कारण बनता है

In most cases, the cause is unknown. In some cases an abnormally formed artery or vein near the nerve is the culprit. The blood vessel can compress the nerve and cause problems. Rarely, TN may occur as a symptom of another underlying disorder, such as:

  • Tumor in the brain or head
  • मल्टीपल स्क्लेरोसिस
  • दाद

जोखिम कारक

These factors increase your chance of developing TN. Tell your doctor if you have any of these risk factors:

  • आयु: 50 या उससे अधिक
  • लिंग: महिला
  • Certain conditions (eg, multiple sclerosis, high blood pressure)

लक्षण

The main symptom is searing pain on one side of the face. The pain may be felt inside the mouth or in the lips, cheek, chin, nostril, ear, or near the eye. Rarely, pain may occur in the eye or forehead. Twitching or wincing sometimes accompanies the pain.

The pain is typically sudden, severe, and stabbing. Even though the pain is often brief (less than two minutes) it can reoccur hundreds of times per day. Attacks can become totally disabling. They may seem to occur at random or be triggered by extremes of temperature, washing, shaving, touching, or tickling the face. There are usually no symptoms between attacks, except perhaps a dull ache.

निदान

डॉक्टर आपके लक्षणों और चिकित्सा इतिहास के बारे में पूछेंगे। एक शारीरिक परीक्षा ली जाएगी।

Tests may be done to help diagnosis underlying conditions that may lead to TN. These may include:

  • CT scan —a type of x-ray that uses a computer to make pictures of structures inside the head
  • MRI scan —a test that uses magnetic waves to make pictures of structures inside the head

You may be given the antiseizure medication (eg, carbamazepine ). This medicine may reduce pain and is sometimes used to help diagnose the disorder.

उपचार

Treatment usually begins with medicine. If medicine fails, other options are available.

दवाएं

दवाओं में शामिल हो सकते हैं:

  • Carbamazepine
  • Other antiseizure medicines (eg, phenytoin , gabapentin , lamotrigine , oxcarbazepine , pregabalin , topiramate )
  • Low-dose antidepressants (eg, amitriptyline , clomipramine )
  • Muscle relaxer (eg, baclofen )
  • Other medicines, such as sumatriptan (Imitrex) injection, lidocaine nasal spray, pimozide (Orap)

सर्जरी

सर्जिकल विकल्पों में शामिल हैं:

Surgery can be highly effective in some cases. The most common procedure is microvascular decompression.

अन्य उपचार

These procedures may be somewhat less effective than microvascular surgical decompression. But, they are widely used, especially in older patients.

  • Stereotactic radiosurgery
  • Injections of alcohol or glycerin to deaden the nerve
  • Injections of pain relievers or steroids to decrease inflammation/irritation of the nerve
  • High-frequency radio waves to deaden the nerve
  • Botulinum toxin injection (Botox)

रोकथाम

There are no guidelines for preventing TN. However, once you have it, steps that may help prevent attacks include:

  • Eating soft foods
  • Eating food and drinking beverages that are room temperature
  • Washing your face with cotton pads and warm water
  • If tooth brushing triggers attacks, rinsing your mouth with warm water after eating
  • Avoiding or minimizing known triggers (eg, heat, cold, touch)
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