Can Trigeminal Neuralgia Be Psychological & Can B12 Deficiency Cause It?

Trigeminal neuralgia affects the body both physically and psychologically. The physical symptoms can be managed by adopting an optimum treatment strategy while psychological management requires counseling apart from medications. Fear of trigeminal neuralgia attack in patients may lead to sleep disorder, depressive disorder, and panic disorder. Patient experiences high stress which in turn leads to further worsening of the condition. Vitamin B12 is a major vitamin that helps to improve the nerve function and in maintaining nerve health.

Can Trigeminal Neuralgia Be Psychological?

Trigeminal neuralgia has a devastating impact on the psychological health of the patient. It is not a psychological condition as not all the people with abnormal psychological behaviors suffers from trigeminal neuralgia. Further, in the diagnosis of trigeminal neuralgia, brain images of many patients reveal the exact cause of trigeminal neuralgia.

Further, patients with this condition also have underlying conditions such as cyst, tumor or multiple sclerosis further, various abnormal psychological behaviors such as stress, depression, and anxiety develop because of trigeminal neuralgia. It is actually a vicious cycle where patient experiences stress and anxiety and these psychological behaviors further worsen the symptoms of trigeminal neuralgia. Excruciating pain and constant fear of trigeminal neuralgia attack make the life stressfull2. This is primarily the reason that neurologists are also adopting strategies to manage the psychological abnormality in the patients apart from physical pain and discomfort. At least one study concludes that trigeminal neuralgia increases the risk of developing the depressive disorder, sleep disorder, and anxiety disorder3.

Can B12 Deficiency Cause Trigeminal Neuralgia?

Although vitamin B12 is a water-soluble vitamin, unlike other water-soluble vitamins, Vitamin B12 does not gets readily excretes from the body rather it gets stored in kidney, liver and other tissues4. Both cobalamin vitamins, i.e. cyanocobalamin and methylcobalamin are important for proper nerve health and assists in normal nerve conduction. Long ago, in 1953-54, large doses of vitamin B12 were administered to the patients to alleviate the symptoms of trigeminal neuralgia. It has also been identified at almost 23% of the patient suffering from trigeminal neuralgia are also suffering from low Vitamin B12 syndrome. It has also been seen that deficiency of vitamin B12 causes facial neuralgia, which is independent of peripheral neuropathy and trigeminal neuralgia. This indicates the importance of vitamin B12 in maintaining nerve health5.

Trigeminal neuralgia is the condition characterized by sudden and unpredictable pain in the facial area. The condition in most cases is caused due to the compression of the trigeminal nerve by the blood vessels present near to nerve. Other causes include cysts, tumor, and multiple sclerosis. In rare cases, trigeminal neuralgia may also be caused due to arteriovenous malformation. However, the attack of trigeminal neuralgia occurs after a remission period. Various triggers transform trigeminal neuralgia remission to trigeminal neuralgia attack. These triggers include:

Talking1: People with trigeminal neuralgia have may initiate or worsen the symptoms because of speaking for a long time. This may be due to the creation of facial pressure.

Smiling: Smiling and laughing also acts as a trigger for trigeminal neuralgia. This may be due to alteration in the state of facial muscles that leads to trigeminal neuralgia attack.

Facial Activities: Facial activities like shaving, make-up and washing face may cause trigeminal neuralgia attack.

Touching And Brushing: The patient becomes so sensitive in trigeminal neuralgia that tough of the face may also cause pain. Further, brushing the teeth and eating are also triggers for trigeminal neuralgia. Drinking cold or hot drinks may also lead to pain.

Stress: Stress is not the trigger factor for trigeminal neuralgia. Trigeminal neuralgia itself leads to stress and worsening of symptoms.

Conclusion

Trigeminal neuralgia has two phases; the attack phase and the remission phase. The problem is that the patient in remission stage does not know about the attack phase. This uncertainty and unpredictability cause abnormal psychological conditions. Many patients with trigeminal neuralgia have found to have a low level of Vitamin B12.

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