Raising Awareness For Those With Trigeminal Neuralgia, Anesthesia Dolorosa, and Brain Tumors
Raising Awareness For Those With Trigeminal Neuralgia, Anesthesia Dolorosa, and Brain Tumors
Jason Thompson and I discuss my condition Trigeminal Neuralgia Anesthesia Dolorosa.
Trigeminal neuralgia (TN), also known as tic douloureux and the “suicide disease," is sometimes described as the most excruciating pain known to humanity. Trigeminal Neuralgia is a form of neuropathic pain (pain associated with nerve injury or nerve lesion.) The typical or "classic" form of the disorder (called "Type 1" or TN1) causes extreme, sporadic, sudden burning or shock-like facial pain that lasts anywhere from a few seconds to as long as days per episode. The “atypical” form of the disorder (called "Type 2" or TN2), is characterized by constant aching, burning, stabbing pain. The teeth are affected in both 1 and 2 and often feel like they are being electrocuted or breaking. The muscles on the affected side waiver from being torn off of the face to severe constriction. When the area around the eye is in pain, it often feels like the patient cannot open the eye or the eye itself feels like it is being pushed out of the socket.
Both forms of pain may occur in the same person, sometimes at the same time. The intensity of pain can be physically and mentally incapacitating. The trigeminal nerve is one of 12 pairs of nerves that are attached to the brain. The nerve has three branches that conduct sensations from the upper, middle, and lower portions of the face, as well as the oral cavity, to the brain. The ophthalmic, or upper, branch supplies sensation to most of the scalp, forehead, and front of the head. The maxillary, or middle, branch stimulates the cheek, upper jaw, top lip, teeth and gums, and to the side of the nose. The mandibular, or lower, branch supplies nerves to the lower jaw, teeth and gums, and bottom lip. More than one nerve branch can be affected by the disorder. Rarely, both sides of the face may be affected at different times in an individual, or even more rarely at the same time (called bilateral TN).
What are the symptoms of trigeminal neuralgia?
Pain varies, depending on the type of Trigeminal Neuralgia, and may range from sudden, severe, and stabbing to a more constant, aching, burning sensation. The intense flashes of pain can be triggered by vibration or contact with the cheek (such as when shaving, washing the face, or applying makeup), brushing teeth, eating, drinking, talking, or being exposed to the wind.
Trigeminal Neuralgia attacks often worsen over time, with fewer and shorter tolerable-pain periods before severe attacks recur. Eventually, the tolerable pain intervals disappear and medications, if they even worked, becomes less effective. The disorder is debilitating. Due to the intensity of the pain, many individuals avoid daily activities and social contacts because the intensity of the pain of so unpredictable.
There is no cure.
Source: National Institute of Neurological Disorders and Stroke
Michele
Anesthesia Dolorosa (AD) is one of the most dreaded complications of brain surgery or the treatment of trigeminal neuralgia. It occurs when the trigeminal nerve is damaged resulting in numbness in the face, with pain present within the numb area.
The two main symptoms of AD are facial numbness (much like the numbness from a dental anesthetic injection) and constant pain. The pain is usually burning, pulling, or stabbing but can also include a sharp, stinging, shooting or electrical component. Pressure and “heaviness” can also be part of the pain symptoms. Often there is eye pain. Cold increases the feeling of numbness, sometimes making a face feel frozen.
Unfortunately, there is no known effective treatment for AD. A multidisciplinary, pain-management-oriented approach is most appropriate. Some helpful strategies include anticonvulsants, antidepressants, opiates, psychological support, and complementary and alternative therapies. There are no good surgical options at this point, but motor cortex stimulation has shown some promise in preliminary studies.
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