“TRIGGERS” DO…
I’ve met with hundreds of patients suffering from all kinds of facial pain, especially trigeminal neuralgia.
They all tell me fairly similar stories. In the beginning, people tell me that their pain started “out of the blue” and felt like an “electric shock”, or a “jabbing” or “stabbing” on one side of the face that would get “triggered” when something pretty specific happened.
Most often, very normal, everyday things would cause their pain to flare up such as:
- Applying makeup
- Brushing their teeth
- Eating
Drinking
- Talking
- Chewing
- Washing their face
- Taking a shower
Some people even keep journals and discover patterns that might contribute to more severe or more frequent episodes of pain such as:
- Stress
- High blood pressure
Certain acidic food (bananas, fruits)
Lack of sleep
Changes in weather patterns
To help people discover their own triggers and patterns, I’ve asked many people to use their mobile devices or notebooks to help them track and understand their own triggers and patterns. Most often, once people understand their triggers and patterns, they try desperately to avoid these things in an attempt to minimize or reduce the number of severe pain attacks or flair ups the experience. Over time, painful flare ups can happen even without provoking the pain and this is when people often seek out professional help to relieve their facial pain.
What is trigeminal neuralgia and what is going on inside your body?
Trigeminal neuralgia is also called tic douloureux.
“In 1756, Nicholas André conceptualized TN in terms of convulsive behavior. He believed that the grimaces of pain his patients expressed suggested that TN belonged to the same spectrum of diseases as tetanus or spasms. He coined the term tic douloureux to reflect both the pain his patients described as well as the facial spasms he documented. The name persisted, even though not all patients demonstrated facial tics in conjunction with their pain.”1
Inside the body, the trigeminal nerve (one of 12 paired “cranial nerves”) has often lost some of its protective myelin sheath within the nerve fibers themselves. This loss of myelin can be the result of a “normal” blood vessel pushing on the nerve and causing the nerve to suffer and misfire from time to time. In essence, the trigeminal nerve, which feels your face on one side, is “shorting out” on itself.
When the nerve is triggered by a normal activity, pain signals are created by mistake and this is the internal cause of the trigeminal neuralgia pain.
The same loss of myelin within the trigeminal nerve can happen in people with multiple sclerosis (MS), benign brain tumors (meningiomas), or with other vascular malformations (AVMs). In these situations, the pain of trigeminal neuralgia can also be experienced.
The trigeminal nerve has three branches, kind of like a tree. Each branch is responsible for feeling a specific area of your face. When something touches a specific area, that branch fires a signal back to the root of the nerve where the signal then shorts out on another part of the nerve, setting off or “flaring up” the pain.
Inside the body, the trigeminal nerve (one of 12 paired “cranial nerves”) has often lost some of its protective myelin sheath within the nerve fibers themselves. This loss of myelin can be the result of a “normal” blood vessel pushing on the nerve and causing the nerve to suffer and misfire from time to time. In essence, the trigeminal nerve, which feels your face on one side, is “shorting out” on itself. When the nerve is triggered by a normal activity, pain signals are created by mistake and this is the internal cause of the trigeminal neuralgia pain.
The same loss of myelin within the trigeminal nerve can happen in people with multiple sclerosis (MS), benign brain tumors (meningiomas), or with other vascular malformations (AVMs). In these situations, the pain of trigeminal neuralgia can also be experienced.
The trigeminal nerve has three branches, kind of like a tree. Each branch is responsible for feeling a specific area of your face. When something touches a specific area, that branch fires a signal back to the root of the nerve where the signal then shorts out on another part of the nerve, setting off or “flaring up” the pain.
How can I get some pain relief?
Help for your facial pain is possible and several effective treatments for trigeminal neuralgia exist. More common strategies include:
- Medications
- Oxcarbazepine
- Carbamazepine
- Gabapentin
- Neurontin
- Baclofen
- Microvascular Decompression Surgery (MVD)
- Gamma Knife Radiosurgery (GKRS)
- Percutaneous Rhizotomy
- Pain Stimulation
When considering any intervention, always work with an experienced team of doctors and surgeons as there are pros and cons to every intervention including medication side effects (fatigue, dizziness, etc) or surgical side effects (numbness, persistent pain, etc).
For a more detailed description of trigeminal neuralgia treatment options, click on the links above. To help track your pain, consider our Facial Pain Help app download.
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