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TrigeminalNeuralgia

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TrigeminalNeuralgia TrigeminalNeuralgia Document Transcript

  • T rigeminal Neuralgia What is trigeminal neuralgia? What are the types of trigeminalUniversity ofPittsburgh pain? Trigeminal (try-GEM-in-ol) neuralgia (noor-Medical Center AL-ja) is a nerve disorder. With this disorder, There are 3 types of trigeminal pain: typical,Information you get sudden bursts of very intense pain atypical, and transitional.for Patients on one side of your face. It is felt in the area of your lips, gums, cheek, or chin. The pain Typical lasts only a few seconds or minutes, but it’s • The pain is sharp, like an ice pick or so intense that you may wince. Some people a shock. described the pain as lightening bolts, knife • The pain comes and goes for short or long thrusts, or electric shocks. periods of time. Another name for the disorder is tic (TICK) • The pain disappears for short or long douloureux (doo-luh-ROO), which means periods of time. “painful twitch.” Most people who develop the disorder are over age 50, but younger • The pain has triggers that you can identify. people can have it too. This disorder affects Atypical more women than men. • The pain can be burning, aching, or throbbing, as well as sharp or stabbing. What triggers the pain? • The pain may or may not disappear for Triggers affect some people who have trigemi- periods of time. nal neuralgia. A trigger is anything that can • The pain has no known triggers. start or set off the pain. For example, lightly touching your mouth or face, talking, eating, Transitional drinking cold drinks, brushing your teeth, or The pain is both typical and atypical. wind on your face may trigger pain. Some people with trigeminal pain do not seem to be affected by triggers. continued
  • TRIGEMINAL NEURALGIA What causes the nerve disorder? Surgery Surgery may be necessary if treatment with The medical name for nerve pain is “neu- drugs is not effective. ralgia.” Trigeminal neuralgia affects a large nerve in the face called the trigeminal nerve. Microvascular decompression. An operation The nerve becomes irritated, causing pain. called microvascular (my-crow-VAS-kyoo-ler) For example, an artery or a vein may be decompression removes the pressure that isUniversity of pressing against the nerve. The blood ves- against the nerve . During the operation, thePittsburghMedical Center sel may rub against the nerve each time the surgeon makes an incision behind the ear toInformation heart beats. The repeated contact can start reach the trigeminal nerve. A small pad is thenfor Patients to wear down the nerve’s protective cover- placed between the trigeminal nerve and the ing. This can lead to periods of severe pain. blood vessel pressing on it. The pad stops the blood vessel from irritating the nerve. This procedure usually gives long-term pain relief. How is this disorder detected? If pain continues, low-dose anti-convulsants Your doctor will ask about your symptoms can help control pain. Sometimes repeating and your overall health. You will have a the procedure gives relief. physical exam and a nerve exam. You also Other surgical procedures. Another way to may have MRI (magnetic resonance im- reduce pain is to damage the trigeminal nerve. aging) of your head to check for possible The result is numbness in the area where the causes of your face pain. The exams and test pain was felt. Sometimes the numbness is per- may rule out other possible causes of your manent. Surgical procedures used include: pain. If so, your doctor may diagnose the pain as trigeminal neuralgia, based on the • glycerol injections — Shots are given under symptoms. the facial skin to numb the area. • Gamma Knife surgery — A focused, high How is the disorder treated? dose of radiation is delivered to the trigeminal root. Medicine • electrocoagulation (ee-LEK-tro-ko-ag- The first treatment usually prescribed is you-LAY-shun) — An electric current is medicine. The drugs most often used are passed through an electrode to nerve fibers. anti-convulsants. These drugs help to reduce • balloon compression — A tiny balloon at trigeminal nerve impulses and so relieve the end of a very fine tube is inserted and pain. Examples are carbamazepine (brand then inflated against the nerve. name Tegretol), phenytoin (Dilantin), oxcarbazepine (Trileptal), and gabapentin These procedures may relieve the pain for (Neurontin). Over time, the pain may years. They are an option for people with MS become more severe. So the drug or its (multiple sclerosis) or other health problems dosage may need to be changed. that rule out microvascular decompression. 2 continued
  • TRIGEMINAL NEURALGIAFor more informationOther helpful resources include:Trigeminal Neuralgia Association2801 S.W. Archer Road, Suite CGainesville, FL 32608Phone: 352-376-9955Fax: 352-376-8688E-mail: tnanational@tna-support.orgWeb: http://www.tna-support.orgAmerican Chronic Pain Association(ACPA)P.O. Box 850Rocklin, CA 95677-0850Phone: 1-800-533-3231Fax: 919-632-3208E-mail: ACPA@pacbell.netWeb: http://www.theacpa.org 3
  • TRIGEMINAL NEURALGIAUniversity ofPittsburghMedical CenterInformationfor Patients For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Pittsburgh, PA, USA The University of Pittsburgh Medical Center is an equal opportunity employer. Policy prohibits discrimination or harassment on the basis of race, color, religion, na- www.upmc.com tional origin, ancestry, sex, age, marital status, familial status, sexual orientation, disability, or veteran status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in© University of Pittsburgh Medical UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.Center 2005SYS237870 BPI/JDS REV 05/05 This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information forForm # 7819-82190-0505 your health care needs. Ask your own doctor or health care provider any specific medical questions that you have.