Pain

Trigeminal Neuralgia

Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain.

Best Trigeminal Neuralgia Clinic in Mumbai

Welcome to Jaslok Hospital, one of the best Trigeminal Neuralgia treatment Hospitals in Mumbai, where we are committed to providing top-notch care and cutting-edge treatments for patients suffering from this debilitating condition. If you or your loved ones are seeking relief from Trigeminal Neuralgia, look no further, for we are here to offer comprehensive support, compassionate care, and ever lasting solutions.

 

Overview of Trigeminal Neuralgia

Trigeminal neuralgia (TN) is also called tic douloureux (Tic).

The International Association for the Study of Pain (IASP) has defined Trigeminal neuralgia(TN) as “sudden, usually unilateral, severe, brief, sharp shooting and  stabbing, recurrent pains in the distribution of one or more branches of the fifth cranial nerve (Trigeminal nerve) which carries sensation from face to brain.

The pain involves the jaw and lower face; sometimes it affects the area around the nose and upper part of the eye. Strong intense, stabbing, electric shock-like pain is caused by irritation of the trigeminal nerve .

Epidemiological evidences shows the prevalence of TN to be approximately 4–28.9/100,000 persons world­wide. Women are affected 1.7 times more than men. Onset is usually after age 50 years and increases with advancing age.

Hypertension is a risk factor in women, but the evidence is less clear for men.

A history of Trigeminal neuralgia(TN) in a first-degree relative is also a minor risk factor.

What is Trigeminal Neuralgia?

Trigeminal neuralgia is a distressing form of nerve pain that targets the face. It arises when the trigeminal nerve, responsible for relaying sensation from the face to the brain, becomes irritated or compressed, often due to a blood vessel or other issues. The pain typically strikes suddenly, proving intense and electric-like in nature. It can affect one side of the face(mostly) or both.

Symptoms of Trigeminal Neuralgia

If you may get severe shooting or jabbing pain that may feel like an electric shock.

Sometimes, pain affects one side of the face at a time, pain may rarely affect both sides of the face.

You can get a constant aching, burning feeling that may occur before it evolves into the spasm-like pain of trigeminal neuralgia.

You can face shooting or jabbing pain,  “burning”,, “electric shock-like”, “pressure”, “stabbing, that makes you feel like an electric shock. Pain or attacks of trigeminal neuralgia can be triggered by certain actions or movements like,

  • Chewing
  • A cool breeze or air conditioning
  • Brushing your teeth
  • A light touch
  • Shaving or putting on make-up
  • Swallowing
  • Talking
  • Head movements
  • Vibrations, such as walking or a car journey
  • You may get pain more frequent and intense over time.

Pain in areas supplied by the trigeminal nerve, including the cheek, jaw, teeth, gums, lips, or less often the eye and forehead.

 

Learn about the differences between dental pain and trigeminal neuralgia in our blog post: Dental Pain vs. Trigeminal Neuralgia: How They Differ

Know the Causes of Trigeminal Neuralgia

The most common cause of typical TN is arterial/venous compression of the trigeminal nerve in the posterior fossa resulting in focal demyelination of the nerve root entry zone

The theory of neurovascular compression is based on three concepts:

(1) A normal blood vessel compresses the nerve in its course through the basal cisterns;

(2) The nerve is compressed in the root entry zone, the area of transition from central to peripheral myelin, which is particularly sensitive to pressure.

(3) Compression results in demyelination and ephaptic (i.e., extrasynaptic)the transmission of impulses from touch fibers to pain fibers, which results in the paroxysms of pain.

Focal demyelination of the nerve root entry zone leading to TN  can also occur secondary to lesions such as tumors, cysts, or multiple sclerosis (also called SYMPTOMATIC TN).

What Causes Trigeminal Neuralgia to Flare Up

Trigeminal Neuralgia flares can be triggered by seemingly harmless activities, such as eating, drinking, or even a gentle breeze against the face. While the precise cause of these sudden flare-ups of pain is not entirely known, recognizing and steering clear of potential triggers can play a vital role in effectively managing the condition.

Trigeminal Neuralgia Diagnosis and Treatment in Mumbai

Diagnosing Trigeminal Neuralgia requires a thorough evaluation of the patient’s medical history, a neurological examination, and imaging tests like MRI or CT scans. At Jaslok Hospital, our team of experienced specialists follows a comprehensive approach to accurately diagnose Trigeminal Neuralgia.

Trigeminal Neuralgia Diagnostic Criteria

Diagnosing trigeminal neuralgia involves a detailed medical history, physical examination, and sometimes imaging tests like MRI or CT scans, althoughthe diagnostic criteria is mainly clinical.Other criterias are:

  • Characteristic Pain Patterns

    The presence of sudden, severe, and stabbing facial pain along the distribution of the trigeminal nerve.

    • Absence of Neurological Deficits

    The pain should not be associated with any neurological deficits or other medical conditions that could explain the symptoms.

    • Response to Medication

    Patients might experience some relief from anticonvulsant medications like carbamazepine, further supporting the diagnosis.

Trigeminal Neuralgia Medication

  • AED/ Anticonvulsants (Carbamazepine, Oxcarbazepine, Gabapentin, Pregabalin, Lamotrigine, Vixotrigine)
  • BOTULINUM TOXIN/ OnabotulinumtoxinA

Surgery for Trigeminal Neuralgia

  • Nonablative procedures

    • Posterior Fossa Exploration / Microvascular decompression (MVD)
    • Peripheral nerve stimulation
    • Motor cortex stimulation (???)
  • Ablative procedures

    • Lesioning (Radiofrequency Thermocoagulation, Balloon Compression Rhizolysis, Glycerol Rhizotomy, Stereotactic Radiosurgery, Nucleus Caudalis dorsal root entry zone lesioning)

Neuromodulation

  • Peripheral Nerve Neuromodulation (PNS)
  • Subcutaneous Peripheral Nerve Field Stimulation (SPNFS)
  • Transcutaneous Electrical Nerve Stimulation (TENS)
  • Gasserian Ganglion Stimulation (Neuromodulation for Trigeminal Neuropathy)

Trigeminal Neuralgia Management

Beyond medical and surgical interventions, effectively managing trigeminal neuralgia involves implementing specific lifestyle adjustments and self-care strategies. Our team offers comprehensive guidance on the following aspects:

  • Stress Management

Stress can intensify episodes of pain, and acquiring stress-reduction techniques can prove beneficial in easing the condition’s impact.

  • Dietary Recommendations

Steering clear of trigger foods and adhering to a balanced diet can aid in managing the condition and its symptoms.

  •  Oral Health

Maintaining excellent oral hygiene and prioritizing dental care are crucial, as even routine dental procedures can trigger painful episodes.

Patient Support and Follow-up Care

At Jaslok Hospital, we go beyond medical treatments and extend our support to patients and their families throughout their journey with Trigeminal Neuralgia. Our patient support programs offer valuable resources, educational materials, and emotional assistance to foster a sense of community and understanding.

Why Jaslok Hospital for Trigeminal Neuralgia in Mumbai?

Jaslok Hospital is renowned for its excellence in neurology and neurosurgery. Our state-of-the-art facilities, coupled with the expertise of our skilled medical professionals, make us a trusted choice for treating Trigeminal Neuralgia. We prioritize the well-being of our patients and aim to provide a comfortable and nurturing environment for their recovery.

Best Trigeminal Neuralgia Treatment Doctors in Mumbai

Our esteemed team of doctors at Jaslok Hospital includes some of the finest Trigeminal Neuralgia specialists in Mumbai. Their dedication to excellence, along with their empathetic approach, ensures that patients receive world-class care.  The team is led by the best Neurosurgeon in India, Dr Paresh K Doshi. They possess a deep understanding of the condition and employ the latest medical and surgical advancements to ensure the best possible outcomes for our patients.