Trigeminal nerve is the 5th cranial nerve that supplies sensation to face from brain. The word neuralgia refers to severe pain along the course of nerve, caused due to nerve damage or irritation. It is one of the widest reaching nerves in the head and when it gets affected causing pain, it is called as trigeminal neuralgia. Pain involves the lower jaws, face and areas around nose and eyes. The pain can be intense like electric shock due to irritation of trigeminal nerve supplying branches of forehead, cheek, and lower jaw. Pain is mainly one-sided.
Symptoms
The symptoms of trigeminal neuralgia are:
• Depending upon the type of trigeminal neuralgia pain may vary from severe, sudden, stabbing, and aching with burning sensation.
• Pain can be triggered by vibration or touching cheeks while washing face, shaving or by applying makeup. Other factors like brushing teeth, drinking, eating, talking or even after draft of wind.
Causes
The causes of trigeminal neuralgia are:
• A blood vessel pressing on trigeminal nerve as it exits the brain stem causing damage or wearing away myelin sheath (protective coating of nerve).
• Multiple sclerosis
• Tangle of arteries and veins (arterioveneous of malformation) injury to nerve (oral surgery) stroke and facial trauma.
Diagnosis
Based on history obtained from patient, it is important to rule out other disorder that cause facial pain like herpetic neuralgia, temporomandibular joint disorder. MRI scan to verify pain is due to multiple sclerosis or tumor that is pressing on nerve root.
Treatment
Treatment includes medicine, surgery, and complementary approaches.
Anticonvulsant medicine (to block nerve firing)
Surgical – Rhizotomy procedure done to block pain from damaged nerve fibers.
Complementary approaches – Complementary techniques along with medication like yoga, aroma therapy, acupuncture, nutrition therapy or botulinum toxin to block activity of sensory nerve and balloon compression (to block pain).
HOMOEOPATHIC MEDICINE
SPIGELIA
Trigeminal neuralgia generally onset of pain comes and goes suddenly. The face is pale with yellow circles round the eyes. Redness of face along with perspiration on face is observed. Lips and cheeks at one time are deep red and another time pale. Pains which are mostly on left sided may vary from violent,jerking, stabbing, tearing, and burning sensation like hot needles or wires. Pain is violent in nature cannot bear least moment or slightest touch with shining swelling of affected side. Periodic neuralgia from morning to sunset that gets worsens from motion and noise. Semi lateral pains in face with praecordial grate agitation and anxiety.
MAGNESIA PHOSPHORICA
Remedy for right side trigeminal neuralgia. Pain may vary from shooting, stitching, stabbing, and cutting which may return ever 2 or 3 hourly. Pain that alternates with toothache and may frequently changes its location, rushing like bolt of lightning. Cold application, motion, draft of air, cold washing aggravates pain. Warm application and pressure relives or feel better for pain. Patient keeps lamenting all the time about the pain.
SANGUINARIA CANADESIS
Right sided trigeminal neuralgia extends in all direction and accompanied by burning and redness of the cheeks. Pain is better by kneeling and by pressing the head against the floor. Tenderness and fullness behind angle of jaws gets aggravated by motion, touch and at night but better by sleep and darkness. Circumscribed redness of both cheeks and there is sensation of rigidity and fullness with bloated face, distended veins, feels stiff and sore to touch.
VERBASCUM THAPSUS
Facial Neuralgia of the left side of face commonly in temporomaxillary joint and cheeks, their pressure felt on entire left side of face and head. Pain gets triggered by talking, sneezing and change of weather. While eating pain is like sticking, numbness and piercing type which extends to upper teeth of same side after few hours. Nature of pain is tearing, cramping, stitching, and crushing appearing periodically in same hour in the morning and afternoon every day. Facial pain is triggered by smallest movement. Left sided neuralgia of face along with coryza and lachrymation and sensation as if parts were crushed with tongs, even after sneezing, talking and with change of weather or temperature.
COLOCYNTH
Colocynth is left sided remedy with pale face, sunken eye with shooting pain tearing and burning in the face on left side along with cramp like sensation in left malar bone extending in left eye. Pain is around left eye which gets aggravated in night around 10 pm and are better by hard pressure, warm and rest. Neuralgia with chilliness and teeth seems too long and there is also echo of sound felt in ears.
HYPERICUM PERFORATUM
Facial pain is sharp, tearing shooting or violent with marked tingling numbness in the affected area. Facial neuralgia along with toothache and these remedy is considered after injury of facial nerve. Neuralgic pain is excessively sore mainly when temperature or weather changes, which tends to appear suddenly and depart slowly.
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