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The trigeminal
nerve is often referred to as the great sensory nerve of the head.
The trigeminal nerve originates in an area of the brain called the
pons, and is made up of parts related to both feeling (sensory)
and movement (motor). There are two trigeminal nerves, one for each
side of the head and face. The nerve affects feeling to the skin
of the cheek, upper lip and upper teeth, and sensory impulses from
the chin, inside the mouth, lower teeth, and front two-thirds of
the tongue. When the trigeminal nerve becomes irritated, the result
can be the painful condition known as trigeminal neuralgia.
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It is not known what causes trigeminal neuralgia. Many experts
believe that pressure by adjacent arteries against the trigeminal
nerve near its entry into the brain causes most cases of the disease.
Trauma, infection of the teeth or jaw, as well as flu-like illnesses
may contribute to the disorder. Pressure on the nerve by an aneurysm,
tumor, or inflammation can produce nerve irritation which results
in symptoms of trigeminal neuralgia. Pain from trigeminal neuralgia
causes a great deal of suffering and limitation of activities
of daily living.
Symptoms of trigeminal neuralgia include:
- Severe pain (similar to an electric shock) in the face, mouth,
or teeth of the affected side.
- Heightened sensitivity around the mouth and nose, which,
when touched, may trigger an attack. Other things such as exposure
to cold, eating or drinking, particularly cold liquids or food,
brushing the hair or teeth, or washing the face may also trigger
attacks.
- Involuntary contortions (also known as tic douloureux) of
the face in response to the pain.
- Bouts of pain for several weeks or months in a row, followed
by a spontaneous cessation of symptoms. Periods of remission
may last for days or years, but they tend to become shorter
as the patient ages.
Many therapeutic methods, including medications, local nerve blocking,
surgical, and radiosurgical procedures, have been developed in an
effort to treat trigeminal neuralgia. Your physician will talk to
you about the appropriate treatment for you and possible side effects.
In Gamma Knife Radiosurgery, a single highly concentrated dose
of ionizing radiation is delivered to a small, precise target
at the trigeminal nerve root. Gamma Knife Radiosurgery is non-invasive
and avoids many of the risks and complications of open surgery
and other treatments. Treatment results in long-term pain relief
in nearly 90% of the patients. Some loss of sensation (numbness)
occurs in 10% to 15% of treated patients.
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