(NaturalNews) Since the first century A.D., trigeminal neuralgia (TN) has been regarded as one of the most painful and enigmatic diseases known to man. TN is a severe, generally unilateral neuropathic pain located within the sensory distribution of cranial nerve five (CN V), the trigeminal nerve. It has been generally accepted that patients will never be completely free from the condition regardless of the therapy. TN is oftentimes misdiagnosed as atypical facial pain, temporomandibular disorders, headaches, and toothaches. The problem with this is that the treatment options are quite different depending on the diagnosis. Teeth are often extracted in error, nerves are incorrectly severed, and people oftentimes take medications with serious side effects only to find that their pain has not gone away. TN can only be diagnosed on clinical features, so a thorough history is paramount. Zakrzewska provides the following as gold standards to prevent misdiagnosing patients due to common differential diagnoses attributed to facial pain:
• Each single burst of pain lasts on average under two minutes •There is no pain between burst of pain •Most patients will have complete remission of pain for weeks or months, at least initially •The pain is described as sharp, shooting, electric shock-like •The pain is provoked by light touch activities, but attacks of pain can also be spontaneous •The pain is always located in the distribution of the trigeminal nerve and first division trigeminal pain is rare •The severity of the pain can vary, especially if medication is used. However, when the disorder is at its peak, the pain is suicidal. It grossly impairs quality of life and leads to weight loss. •Sleep disturbance tends to occur if the pain is severe •Depression is often noted and there are reports of patients committing suicide or feeling suicidal •Extremely rare to have any autonomic symptoms or signs • In atypical trigeminal neuralgia patients, report prolonged pain of a lowered intensity and quality (i.e. burning, tingling or dull, after the main attack of pain).
Without knowing when the next painful attack will occur, people with TN find themselves terrified to do even the most remedial tasks like brushing their teeth or combing their hair because they're afraid they may trigger a paroxysm. Their lives are spent in a constant state of tension and anxiety; fearing this unknown. Thus, depression and suicidal tendencies are common and should be noted to confirm diagnosis when reviewing the patient's history. The literature confirming the suicidal tendencies of someone suffering through TN paroxysms is alarming. Burcon notes that approximately half of those people who live with TN for more than three years commit suicide; thus, TN has been coined "the suicide disease" by lay people. The other coined term, tic douloureux, refers to the accompanying unilateral grimace precipitated by the pain.
The significance of determining an accurate diagnosis is vital to ensure proper treatment and to prevent malpractice. Significant side effects from unnecessary tooth extraction, improper drug administration, and surgical procedures should be avoided at all costs. Contact your natural healthcare provider if you suspect that you suffer from TN.
Sources for this article include:
Eller JL, Raslan AM, Burchiel KJ. Trigeminal neuralgia: definition and classification. Neurosurg Focus 2005; 18(5): 1-3.
Zakrzewska J. Assessment and treatment of trigeminal neuralgia. Br J Hosp Med (Long) 2010; 71(9): 490-494.
Xu-Hui W, Chun Z, Guang-Jian S, Min-Hui X, Guang-Xin C, Yong-Wen Z, Lun-Shan X. Long-term outcomes of percutaneous retrogasserian glycerol rhizotomy in 3370 patients with trigeminal neuralgia. Turkish Neurosurgery 2011; 21(1): 48-52.
Stiles A, Evans J. Trigeminal neuralgia and other facial pain. Neurology 2007; 835-843.
Matsuda S, Nagano O, Serizawa T, Higuchi Y, Ono J. Trigeminal nerve dysfunction after gamma knife surgery for trigeminal neuralgia: a detailed analysis. J Neurosurg 2010; 113:184-190.
Moore KL, Dalley AF, Agur AM. Clinically oriented anatomy 6th ed. Baltimore: Lippincott Williams & Wilkins: 2009. p. 862, 1065 - 1067.
Seeley, RR, Stephens TD, Tate P. Anatomy and physiology 7th ed. Boston: McGraw-Hill: 2006: p. 415 - 461.
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