A relaxed breakfast on Sunday morning. When chewing the delicious bun shoots in a flash in a half of the face a stabbing pain. This is over after a few seconds, but so violent that the tears come. The name is program: Trigeminus, the trilling nerve, is the name for the fifth cranial nerve, neuralgia means nerve pain.
Where does the pain of trigeminal neuralgia come from?
In the case of trigeminal neuralgia, one, more rarely two, of the three branches of one of the two trigeminal nerves hurts the symmetrically large parts of the face:
- The first, rarely affected branch conveys sensations from the lacrimal gland, eye socket and forehead
- the second, most frequently affected branch, supplies facial skin, nasal mucosa, upper lip and maxillary teeth
- the third branch conveys sensations in the lower jaw area and supplies the chewing and floor muscles.
In Germany, about every 3, 000. affected by trigeminal neuralgia; mainly people between the ages of 50 and 70, women a little more often.
How does trigeminal neuralgia develop?
Depending on the cause, the much more common classical trigeminal neuralgia is distinguished from the secondary trigeminal neuralgia that arises at the bottom of other disorders. In the first form, the nerve is irritated by a tight-fitting blood vessel loop for years and eventually damaged its protective cover. This results in a "short circuit" between otherwise separated nerve fibers, so that normal stimuli such as touches are perceived as a pain sensation.
In the case of secondary trigeminal neuralgia, nerve damage occurs, for example as a result of tumor pressure, herpesviruses or multiple sclerosis. Since the cause of the classical form was unknown for a long time, one also speaks of the idiopathic ("with unexplained cause") and the non-idiopathic form.
How is trigeminal neuralgia expressed?
Primary headache and facial pain can be manifested by a wide range of complaints. The pain can range from a few seconds to years. Typical of the classic trigeminal neuralgia are the extremely short, maximum two-minute attacks, but which can occur up to a hundred times a day and are extremely painful - not surprising, the triplet nerve supplies the normally very sensitive facial area.
The pain shoots in a flash, is described as stinging or burning, and is located precisely in the supply area of the affected trigeminal branch.
It is also typical that the attacks are often triggered by contact with the area or certain activities: chewing, talking, brushing, shaving, etc. Sometimes tears or salivation, skin redness or muscle twitching occur in the affected half of the face.
The pain is usually so unbearable that sufferers lose weight for months because they are afraid to chew, and they are often suicidal. If the trigeminal nerve is irritated by another underlying disease, such as tooth rooting, the symptoms may also be atypical: the pain lasts longer, but less severely, or the area around the nerve is numb.