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What is Trigeminal Neuralgia?

The name says it all. 

Trigeminal is the name of the 5th cranial nerve that supplies sensation to the face.  You have one Trigeminal Nerve for each side of the face that travels from the brain stem, through the brain, exits the skull near the ear through a small hole called Meckel’s Cave, and then branches over each half of the face.  It has three primary branches: 1. Over the eye, 2. Cheekbone, nose, upper teeth, 3. Lower jaw and bottom teeth.

Neuralgia just means pain.  TN is described as among the most painful conditions known to humankind. (Lovely thought, I know.)

The primary job of the Trigeminal nerve is to transmit impulses to the brain, which the brain interprets as sensation.  This can be anything from a light breeze, a slap, a kiss, or a stab.  However with Trigeminal Neuralgia, the nerve is triggered by something, but instead of sending a ‘light breeze’ impulse, it sends an extreme pain impulse to the brain.

The causes of TN in children, other causes, and the different types of Trigeminal Neuralgia are a topic for another post.  For now, we just want to understand this much, Trigeminal Neuralgia is intense pain in the Trigeminal nerve.  The details of each patient’s pain tends to be a bit unique.  However, overall, the most classic manifestation is sharp, stabbing, or electrical type shocks or pains on one side of the face or the other (usually, though bi-lateral does happen), along one or more branches of the Trigeminal Nerve.

Triggers commonly develop with Trigeminal Neuralgia, however this can happen over time.  Initially these may be very hard to determine, and the pain can seem completely random.  However, often certain things such as cold air, cold food/drink, chewing, teeth brushing, and hair brushing will more often set off the pain.  The list of possible triggers is as varied as the patients, and often what sets off one person will not set off another.

My (Meg’s) daughter seemed completely unpredictable in the beginning.  However, over a period of about 6 months, some triggers emerged.  A couple of times the cool air that came out of the fridge when she opened it set off pain.  A few times brushing her hair out of her eye set her off.  There were still a lot of times it would hit and we had no idea why, but those few times here and there started show us triggers.  By two years in to our journey it was more likely that when the pain hit we would be able to connect it to one of the above, or chewing, teeth brushing, or even breathing through her nose.  However, still, there were plenty of times the pain would hit and we couldn’t figure out what on earth set it off.

The Other Names:

Tic Douloureaux – this name was given because of the “contortions and grimaces of the face” that accompanied the intense pain.

Fothergill’s Disease – so called because in 1773 John Fothergill, an English physician, presented cases of a painful affliction of the face.  His description of Trigeminal Neuralgia has been considered an accurate and clear account of the condition.  Due to his meticulous description of the clinical symptoms, many thereafter referred to the condition as Fothergill’s disease.

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