What Happens To Untreated Trigeminal Neuralgia & When To Go To Doctor?

Roughly about 150,000 people with trigeminal neuralgia (TN) are diagnosed every year. It is seen more in women than in men and usually seen in people more than 50 years however, it can occur in any age group. The exact cause of trigeminal neuralgia is not known completely. Possible pathogenesis can be due to an abnormality in the afferent nerves of the trigeminal root or ganglion. Damage to the axons can make the neurons hyperexcitable and cause pain leading to painful neuropathy or it can be due to vascular compression by nearby blood vessels which can damage and irritate the trigeminal nerve giving rise to the symptoms.

For you to understand what happens to untreated trigeminal neuralgia, you will have to know what are the symptoms and how the disease progress with time.

The most prominent and debilitating symptom of trigeminal neuralgia is facial pain. The pain can come in different patterns to different people and other symptoms can be present or not present.

The pain attack usually occurs spontaneously without any apparent preceding incident, some patients attribute the pain to a previous accident, dental surgery or blow to the face. But most of the time the TN would have been present and the incident triggered the attack.

Two types of trigeminal neuralgia

Typical TN (type I): Episodes of shooting, severe, stabbing pain that might feel like an electric shock. Bouts of pain which lasts for a few seconds to minutes. Episodes of bouts of pain attacks which lasts for days, weeks or months. Some patients have a specific time of the year they get TN. Spontaneous pain attacks that are triggered by chewing, swallowing, touching the face, talking, brushing, shaving, etc. There is definitely a remission phase with no pain or mild pain for months or years.

Atypical TN (type II): Constant burning like pain that gradually becomes a spasm like TN pain. In most patients, the remission stage is not there, the pain will be present continuously.

• The pain is usually on one side of the face involving the cheeks, jaw, gums, teeth, lips and sometimes involve the forehead and eye. Rarely both sides of the face can be involved. Pain starts in one point of the face then gradually spreads to other parts of the face.
• Most patients suffer long stretches of pain episodes followed by weeks, months or years of pain-free period. For some patients, only a few bouts of pain per day but for some several bouts of pain can occur per day. The frequency of attack differs from one person to another. At the end of the episode, facial twitching can be present.
  Other symptoms such as grimace, wince, facial flushing, and excessive tearing can be present.
• The severity and frequency of attacks increase with time were more intensified pain attacks occur more frequently. ^{(1) (2)}

If the above symptoms occur at the initial period itself consult a doctor. Do not wait taking pain killers thinking this will go away after some time and also do not assume it’s due to a dental problem and do unnecessary procedures. It’s best you consult a doctor so that the doctor can decide if it is trigeminal neuralgia or another condition and the doctor will refer you to an appropriate doctor for further treatment depending on the condition. There are many treatment options available for trigeminal neuralgia which can relieve your pain permanently. Therefore, go to the doctor as soon as possible. ⁽³⁾

Trigeminal neuralgia is a chronic pain condition that can reduce the quality of life in many patients if it is not identified properly and treatment is not carried out. Usually, severe, stabbing, spasm-like bouts of pain episodes on one side of the face lasting for days, weeks or months followed by a remission period is the classic presentation.

Sometimes atypical presentation with continuous pain without a remission phase can be present. With time the severity and intensity get worst and the frequency increases too. If you stay without any proper treatment the condition gets worst. Therefore, if you get facial pain consult a doctor as soon as possible.

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