Trigeminal neuralgia

Trigeminal neuralgia is already a very common disease. It can be divided into primary and secondary. Trigeminal neuralgia is very common in middle-aged people over 40 years old, and the proportion of male patients is higher than that of female patients. The most obvious symptom of patients is pain. Many people may not know much about this disease, and they don’t know what’s going on after getting the disease. Let’s take a look at some characteristics of trigeminal neuralgia.

The most prominent feature of trigeminal neuralgia is of course pain. It is a sudden pain that comes in waves. Patients will experience facial muscle twitching. Timely treatment after the onset of this disease is important, and active treatment should be used to avoid worsening of pain.

1. Nature of pain: Sudden paroxysms of pain, manifested as a sudden, severe, lightning-like, short-term throbbing pain at a certain point in the face, mouth and mandible, like a knife cutting, burning, needle-like or electric shock tearing pain, which often occurs when talking, eating or washing the face. Each time it lasts for several seconds or tens of seconds to 1-2 minutes. The pain immediately spreads to the area of ​​one or several branches of the trigeminal nerve. The pain is often so severe that the patient has to stop talking, eating, and walking, and covers the face with both hands. In severe cases, the patient grits his teeth, rubs his face vigorously, and avoids people who are talking. The face becomes red, and the chewing muscles and facial muscles spasm. It is called unifacial myalgic spasm or painful convulsion. The pain can disappear suddenly, and there is no pain at all between two attacks, just like a normal person.

In the early stages of the disease, the pain attacks are less frequent, often after catching a cold, with an intermittent period of several months or years. There are very few cases of spontaneous stop and self-healing. Later, the attacks become more frequent, the pain worsens, and the course of the disease can vary from several years to decades. In severe cases, the attacks occur day and night, dozens or even hundreds of times a day. The patient cannot eat or drink, and becomes emaciated. The patient is in unbearable pain all day long, with a depressed and painful expression, and even loses confidence in life and commits suicide. Some patients have seasonal attacks in the early stages. The pain occurs periodically at a certain time in spring or autumn each year, and each attack lasts 1 to 3 months, and then disappears naturally without any reason until the same season of the following year.

2. Pain location: Pain attacks are limited to the distribution area of ​​the trigeminal nerve, mostly unilateral, more on the right side, and rarely on both sides. The latter often starts from one side and then involves the opposite side, and the pain attack areas on both sides are not necessarily symmetrical, mainly on one side. In the early stage of the disease, it may first be concentrated in a certain distribution area and remain unchanged for a long time. It is mostly in the second or third branch or the area within the second and third branches on one side, and then may gradually spread to other branches, but not spread across the midline to the opposite side. For example, the pain of the first branch is in the upper eyelid and forehead, the pain of the second branch is in the upper lip, gums and cheeks, and there are also people with hard palate pain. The pain of the third branch is in the lower lip, gums and mandible. The tongue pain is rarely involved, and bilateral attacks are occasionally seen.

3. Trigger points: More than 50% of patients have special sensitive skin areas in a certain area of ​​the face. Slight touch, pulling and vibration of the facial muscles can cause an attack. The sensitive area is limited and concentrated at one or two points, which are called "trigger points" or "trigger points". A patient may have several trigger points, which are commonly found on the upper and lower lips, corners of the mouth, wings of the nose, cheeks or gums on the affected side. Any stimulation and pulling of these points will cause an attack. Starting from this point, it will immediately radiate to other parts of the body. Facial stimulation includes talking, singing, eating, washing face, shaving, brushing teeth and wind blowing.

4. Other symptoms: Due to pain and spasmodic twitching of facial muscles, the corners of the mouth may deviate to the affected side. In the early stage of the disease, the face and conjunctiva are red and red, and tears and runny nose occur. In the later stage of the disease, conjunctiva inflammation and stomatitis may occur. Some patients hold their cheeks with their hands and rub them vigorously when the pain occurs in order to relieve the pain. Over time, the skin on the affected side becomes rough and thickened, and the eyebrows become sparse or even fall off.

5. Neurological signs Neurological examination shows no positive signs in primary trigeminal neuralgia except that the corneal reflex is weakened or disappeared in some patients. In a few patients, in the late stage of the disease, the sensation in the painful area on the affected side is reduced, resulting in partial numbness due to alcohol sealing and radiofrequency treatment. In this case, a detailed neurological examination should be performed to rule out secondary trigeminal neuralgia.

Patients with trigeminal neuralgia must pay special attention to their daily diet and health care, learn more about some dietary therapy methods, especially pay attention to the supplementation of vitamin B and calcium, and seek treatment in time. Some patients' conditions become very serious, and they develop depression and suicide, which is very scary at that time. Therefore, active treatment and good care must be provided when the condition is at its mildest.