Trigeminal neuroma is a disorder caused by damage to the trigeminal nerve, resulting in excruciating pain in the face. It can be caused by compression of the nerve by a blood vessel, a tumor, cyst, or aneurysm. Treatment options include medications, surgery, and nonsurgical procedures.
Trigeminal neuroma is a nervous system disorder resulting from damage to the trigeminal nerve. Also known as tic douloureux, trigeminal neuroma affects a cranial nerve in the face that is primarily responsible for chewing and transmitting sensory information, such as pain and pressure. Damage to this nerve can cause excruciating pain in one or both sides of the face, and these painful episodes can occur many times a day.
This condition is thought to be caused by compression of the trigeminal nerve by a blood vessel, which causes the nerve to register pain at sporadic times and send pain signals to the brain at times when there is no pain. Nerve damage is sometimes caused by other conditions, such as a tumor, cyst, or aneurysm. Sometimes a face or tongue piercing can cause damage to the trigeminal nerve.
Nerve damage causes the person to experience multiple flashes of pain without a cause, or the pain could be a result of touching the face, brushing the teeth, or even talking. Air and loud sounds can also trigger an attack. This condition can be progressive, spreading to other areas of the face. The attacks will occur more frequently over time and the pain will become more severe.
If a person experiences this type of pain, a doctor might ask about the person’s health and lifestyle to rule out other causes. Dental problems and postherpetic neuralgia, a condition that results from complications of shingles, must be ruled out. The doctor might order a magnetic resonance imaging (MRI) test to determine if the person has a tumor, aneurysm, or multiple sclerosis. There is no definitive way to diagnose a person with trigeminal neuroma.
If a person’s doctor thinks they have the condition, a course of treatment will be determined. Usually, trigeminal neuroma can be treated with medications, but there are some cases where a surgical procedure may be necessary. Anticonvulsants, antidepressants, muscle relaxants, or pain relievers will be prescribed to control the painful attacks and prevent the disease from getting worse. Surgical options include stereotactic radiation therapy and balloon compression, but these procedures will cause permanent damage to the nerve to prevent it from sending future pain signals to the brain.
Nonsurgical options can help relieve symptoms while still allowing the nerve to remain intact. Glycerol can be injected into the nerve to reduce pain symptoms, and the procedure can be repeated, albeit with less effect. Radiofrequency rhizotomy is another procedure in which a radiofrequency current is used to burn the pain nerve sensors. Microvascular decompression is performed to separate the enlarged blood vessel from the nerve.
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