Trigeminal neuralgia
I've had facial pain on and off for the past couple of months. I've been to my dentist in case a tooth is causing the problem but he could find nothing amiss. He mentioned it could be a problem with my trigeminal nerve. Can you enlighten me?
Trigeminal neuralgia causes facial pain on one side of the face. The pain can be sporadic in nature with attacks varying from several times daily to several times a month. In between attacks, sufferers are usually pain free.
The condition is thought to be caused by blood vessels compressing the facial nerve. It may be caused by a viral infection or in conditions where the outer coating of the nerve is affected. The condition occurs in more women than men and is more common in those over the age of 40. It also tends to affect the right side of the face more so than the left.
The pain can be quite bad at times and usually occurs in my right lower jaw, lower teeth and gums. I've noticed that it tends to come on after eating something really cold.
The trigeminal nerve has three branches - the ophthalmic, maxillary and mandibular. Pain around the eye area usually indicates the ophthalmic branch is involved, while pain around the temple area, upper cheek and part of the nose is due to the involvement of the maxillary branch.
Pain around the cheeks, chin and teeth as you describe are usually the result of the mandibular branch of the nerve being irritated.The trigeminal nerve controls chewing movements and sensations of the face, scalp, teeth and mouth. Often the pain is triggered by specific stimuli, such as eating, smiling, talking, exposure to either hot or cold or even light touch.
What can I do about it?
Following a thorough investigation to rule out any other cause, a diagnosis of trigeminal neuralgia is usually managed using a two-pronged approach. First, preventing an attack is often possible by avoiding the stimuli that trigger the problem. In your case cold food seems to be a trigger for facial pain. You should try to avoid foods or beverages that are served at low temperatures.
Secondly, the degree of pain experienced by some people with the condition can often disrupt everyday life. If the pain is severe it is important that you avail of adequate pain relief measures from your GP or pain specialist to minimise discomfort. In cases where analgesia and preventative measures have been unsuccessful, surgical treatment may be needed.
Marion Kerr