Trigeminal neuralgia (TN), also known as Fothergill Disease or Tic Douloureux, is a condition affecting the 5th cranial nerve. There are two major subdivisions of trigeminal neuralgia, namely Type 1 and Type 2 trigeminal neuralgia. Type 1 (TN1) is characterized by episodes of intense, stabbing pain often affecting the mouth, cheek, nose, and/or other areas on one side of the face. On the other hand, type 2 (TN2) is characterized by less intense pain, but with a constant dull aching or burning pain. Most cases of TN1 are linked to a blood vessel pressing against the trigeminal nerve, however, in some cases; no underlying cause can be identified. As for TN2 cases, it can either be idiopathic, due to compression of the trigeminal nerve, or a known underlying cause such as a tumor or multiple sclerosis is the reason for the condition.
How Common Is Trigeminal Neuralgia Or Is It A Rare Disease?
Trigeminal neuralgia is considered an uncommon disorder, which is characterized by sudden, recurrent episodes of stabbing, shock-like pain that can either be brief (lasting for a few seconds) or last for about two minutes. Most cases are unilateral i.e. only one side is affected at a time, with the right side being affected more than the left, but bilateral cases, where both sides are affected, can also occur.
Trigeminal neuralgia is more prominent in females than in their male counterpart. On top of that, older individuals, 50 years and above, are more likely to develop the disorder than younger people. In younger individuals, the cause is often seen as idiopathic, meaning the underlying cause is unidentified. As for older individuals, most cases are usually because of damage to the central nervous system e.g. in individuals with multiple sclerosis. Children can also develop trigeminal neuralgia, but it is extremely rare. The exact incidences of trigeminal neuralgia cases are unknown, but in some areas, such as the US, approximately 10,000-15,000 new cases occur each year. As for the general population, trigeminal neuralgia has an annual incidence of 4.3 per 100,000 cases.
There are certain factors which increase the likelihood of one developing Fothergill disease and they include; hypertension, tumors, multiple sclerosis, abnormalities of the base of the skull, and arteriovenous malformation. Multiple sclerosis is the disease most commonly associated with trigeminal neuralgia cases and is present in about 1-5% of patients with the condition.
Symptoms of trigeminal neuralgia
An occurrence of trigeminal neuralgia pain is often a result of a triggering effect. For most patients, they have a trigger zone, which is a small area in the central part of the face, either on a cheek, nose, or lip, that, when stimulated, triggers a typical burst of pain. Therefore, any sort of slight altercation on the trigger zone, be it from a light touch, blowing wind, brushing of teeth, shaving, chewing, and even drinking of cold water can cause a trigeminal neuralgia pain attack. The pain can either be localized at a particular point in your face or spread out. Trigeminal neuralgia is progressive and pain attacks worsen over time. In general, this condition is not life-threatening, but the pain can be debilitating enough to interfere with your normal living. Therefore, you will find many individuals avoiding various daily activities including socialization in fear of having a trigeminal neuralgia pain attack.
Trigeminal neuralgia is more common in people who are 50 years and above. However, younger individuals and even infants can develop the condition, but it is very rare, especially in children. People with multiple sclerosis and other conditions which affect the myelin nerve sheath, which is the layer that covers the nerves, are likely to develop trigeminal neuralgia. In rare occasions, trigeminal neuralgia can be caused by nerve compression from a tumor, tangling of arteries and nerves (arteriovenous malformation), or injury to the trigeminal nerve either due to stroke, sinus or oral surgery, as well as facial trauma. In approximation, there are about 12 cases of trigeminal neuralgia per year in a population of 100,000.
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