Definition of Disease: It is a very short-term, lightning-like pain on one side of the face. Facial pain sometimes occurs with eating, drinking cold or hot water, brushing teeth, and sometimes even talking.
Causes of Trigeminal Neuralgia (TN);
1: Primary (arterial, venous pressure)
2: Secondary (Brain tumors, cerebral vascular balls and balloons, head trauma, multiple sclerosis, etc.)
General features of the disease and its incidence;
It is a disease of advanced age and is usually seen in middle and advanced ages, but it is most commonly seen in 50-60 years of age.
Multiple sclerosis is usually responsible if it occurs in young people.
It is more common in women than men.
The left side of the face is more affected than the right side.
3–6% of all TNs are bilateral.
Incidence: It is 100 000/4.7 per year.
Complaints and findings of TN Disease;
It is a very severe facial pain, usually unilateral but rarely bilateral. This pain occurs (rarely) when eating, drinking hot or cold water, talking, brushing teeth and sleeping. Neurological examination is usually normal, and signs and complaints of cerebellum and cranial nerve involvement of the primary disease can be seen in secondary TNs.
Diagnosis of TN Disease;
Today, the diagnosis of this disease is quite easy and can be made with a good history and neurological examination.
Magnetic Resonance (MR), one of the neuroimaging techniques we use in the diagnosis of this disease, can provide very useful information as well as show the causes of facial pain.
Differential Diagnosis of TN Disease;
1: Dental Diseases: It is the most common differential diagnosis, and patients usually have a history of one or more tooth extractions.
2: Sinusitis: Inflammation of the air sinuses
3: Head and neck cancers
4: Head trauma
5: Jaw joint pains
6: Disorders such as atypical facial neuralgia are counted.
TN Treatment;
1: Medical treatment: Anti-epileptics (carbomezapine, diphenyl hydantoin)
2: Surgical treatment
A: Destructive procedures
1: Radiofrequency thermocoagulation
2 : Radiosurgery (gamaknife)
3: Injections into the trigeminal tracts (glycerol, alcohol)
4: Peripheral neurectomy
B: Nondestrictive processes
1: Balloon compression of the percutaneous gasser ganglion
2: Microvascular decompression (MVD)
Currently, the most accepted treatment method in the treatment of trigeminal neuralgia is the MVD surgical technique in suitable patients. If the arterial nerve compression is removed in patients with this surgical technique, the successful result is over 90%. However, destructive procedures are successfully applied to those who are unable to receive anesthesia due to the general systemic condition of the patient.
TN Result;
Stage 1: Complete relief of pain
Stage 2: Recurrence of pain
Stage 3: Absence of pain
