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Trigeminal Neuralgia Diagnosis And Treatment

If you think you may have trigeminal neuralgia and the pain is bad enough you've decided to see your physician, be ready to describe your pain for him with as much accuracy as possible. It can be very difficult to describe pain, but a good description is the first step in getting the treatment you need for this facial pain condition. You health care provider will want to get an idea of the intensity of the pain, which part of your face is affected, how long the attacks last, and what brings on the pain.

Malfunctioning Nerve Branches

The next step will be a neurological examination in which your doctor will look at and touch various areas on your face to discover where the pain occurs. If your doctor thinks you really do have trigeminal neuralgia, he will try to determine which branches of the nerve seem to be malfunctioning.

Since in some cases, trigeminal neuralgia is caused by multiple sclerosis, your physician may decide you should have a magnetic resonance imaging (MRI) scan of your brain—the only definitive test for multiple sclerosis. Because facial pain can originate from many different causes, an accurate diagnosis is primary. Some of the tests your doctor may order will be performed to rule out other conditions.

The first line of treatment for trigeminal neuralgia is pain medication. Most people with the condition respond well to medication and do not require surgery. However, some people have severe side effects from medication, or their condition no longer responds to medication. In these cases, injections or surgery can be viable alternative treatments for this condition.

Effective Medications

Medications that serve to ameliorate or block pain signals are the first line of treatment for trigeminal neuralgia. Anticonvulsants and antispasticity agents are effective treatments for this condition, though sometimes the side effects can be difficult to tolerate and in some cases even dangerous.

When medications fail to achieve the desired aim, alcohol injections are the next step. Alcohol injections give temporary respite from the pain of trigeminal neuralgia by numbing the areas of your face affected by the condition. Your doctor can pinpoint the branch of the trigeminal nerve that is causing your condition and inject alcohol into the corresponding area of your face where the nerve is causing pain. Because this treatment will not bring about a permanent cessation of pain, you'll need to have injections or other treatments when the pain returns.

Last Resort

When other means fail to achieve the desired result, you may decide to have surgery. The primary goal of surgery for trigeminal neuralgia is to stop the compression of the nerve, which is most often caused by blood vessels or arteries that cross its path. In other cases, your doctor may decide that damaging the trigeminal nerve will stop the pain once and for all by preventing the nerve from malfunctioning.