Ask the dentist: New hope for sufferers of trigeminal neuralgia facial pain

IMAGINE the simple act of shaving or smiling eliciting a pain so severe that suffers describe it like being stabbed in the face. Well this is what people with the condition trigeminal neuralgia (TN) have to deal with sometimes on a daily basis. Current medication for this debilitating disease often leaves sufferers walking around in a fog-like state; however, a recent study into a new drug is giving a glimmer of hope.

About 4,000 new cases of TN are being diagnosed in the UK each year. Typically TN affects more women than men, the majority of whom are pensioners. Around one per cent of all multiple sclerosis patients develop the condition.

TN affects the trigeminal nerve which runs from your brain into your face; the branches of the nerve supply your eyes, jaws, facial muscles and teeth. The sudden facial shock-like attacks can be brought on by the lightest of touches from for example a gentle breeze, shaving, speaking, eating or smiling. They usually last for a few seconds but there can be many bursts of pain in quick succession.

It’s no wonder that this depressing affliction is regarded as one of the most painful conditions that’s known in the medical world.

More research still needs to be undertaken into TN but it’s basically thought that it happens when the nerve malfunctions and pain messages are sent at inappropriate times. There are several possible causes of damage, including pressure from blood vessels.

Pain signals reach the brain via the activation of sodium channels located along the membranes of nerve cells. Blocking this sodium channel by for example giving a local anaesthetic stops the pain. In TN, the nerve damage is presumed to be at the base of the skull. However, this region is hard to reach by local injections and therefore requires drug treatment.

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