Its Name Is as Difficult as the Disease Itself

A Disease That's Difficult in Name and Nature Too! Prof. Dr. Pulat Akın Sabancı explained 7 essential facts about Trigeminal Neuralgia and offered important warnings and recommendations. Are you experiencing severe pain on one side of your face? Pain striking your cheek, jaw, teeth, lips, forehead or under your eyes? And worse, merely touching your face, washing your face, eating, brushing your teeth, or even drinking water can trigger this pain! This little-known disease in society is called Trigeminal Neuralgia! Prof. Dr. Pulat Akın Sabancı, Neurosurgeon at Acıbadem Taksim Hospital states: "Patients typically describe the pain caused by Trigeminal Neuralgia as the most severe pain they have ever experienced in their lives. They report that they were able to tolerate facial pain previously, but it has intensified significantly over time. Some patients receive prolonged dental treatment because the pain is thought to be tooth-related and have multiple teeth extracted for this reason. There are even patients who have attempted suicide due to Trigeminal Neuralgia. Patients experiencing stabbing-type pain in the face should consult a neurosurgeon without delay" he says.

It manifests with these symptoms!

Trigeminal neuralgia is a disease characterized by stabbing-type severe pain on one side of the face. Patients typically consult a doctor due to pain that occurs on the right or left side of the face, frequently radiating toward the cheek, jaw, teeth, lips, and rarely to the area under the eye or forehead. This severe and bothersome pain occurs multiple times throughout the day in brief episodes and manifests as electric shock-like sensations. Prof. Dr. Pulat Akın Sabancı explains: "Some patients move both hands toward the painful area during these severe pain episodes. Attacks can last from a few seconds to several minutes. Pain may be localized at a single point or spreading, initially mild but intensifying over time. In some patients, daily activities such as touching the face, washing the face, eating, consuming fluids, or brushing teeth can trigger pain. These pain attacks may occur in cycles; sometimes there are no attacks for days or weeks, followed by frequent attacks again" he explains.

Lack of public awareness delays treatment!

Prof. Dr. Sabancı noted that Trigeminal Neuralgia is not as commonly seen in society as hypertension and diabetes, nor is it frequently mentioned in public health information campaigns, and explained as follows: "In fact, healthcare workers in other specialties rarely think of it. Although it is an easily resolved disease with a correct diagnosis, patients who do not receive appropriate referral go through a difficult preliminary treatment period. For example, in the histories of a significant portion of patients we treat for trigeminal neuralgia, we hear that these patients previously received prolonged dental treatment because the pain was thought to be tooth-related and multiple teeth were extracted for this reason."

No early warning signs!

From the onset of the disease, it presents with pain symptoms characteristic to itself. There is no possibility of it showing signs beforehand or taking preventive measures before it appears. Early diagnosis offers no benefit.

These factors can cause it!

Prof. Dr. Pulat Akın Sabancı states that the cause of the disease is compression of the Trigeminal Nerve (which gives the condition its name) by any factor such as blood vessel compression or tumor compression, and notes: "In tests performed on patients with this condition, it is often found that one of the main arterial structures in that region of the brain compresses the nerve that provides facial sensation. However, Trigeminal Neuralgia can rarely also occur in the presence of multiple sclerosis (MS) and similar conditions, and in the presence of a brain tumor adjacent to the trigeminal nerve. Trigeminal neuralgia occurring in MS can affect both sides of the face" he states.

The patient's account is very important!

"The most important factor in diagnosing this disease is the patient's account and description of symptoms to the doctor," Prof. Dr. Sabancı continues: "The patient's description of severe, electric shock-like pain that occurs suddenly within the area innervated by this nerve and does not cross to the opposite side of the face is usually sufficient for diagnosis. After establishing the diagnosis, special brain MRI scans aimed at imaging the brainstem must be completed to investigate the cause. If the disease presents as the first sign of MS, then advanced tests for MS diagnosis must be performed."

First, medical treatment

Prof. Dr. Sabancı notes that in patients diagnosed with Trigeminal Neuralgia, special medications used primarily to relieve this pain significantly reduce the stabbing symptoms in the patient's face, and describes the treatment process as follows: "In typical trigeminal neuralgia, the pain controlled by medication in the early years increases in some patients over time. Even if the drug dose is increased, the pain becomes unbearable. If the patient's pain persists despite medication use or there are serious side effects from medication use (such as dizziness and imbalance), surgical treatment comes into consideration. In patients who undergo surgery, two different methods are used: percutaneous method and open microsurgical approach. In the percutaneous method, a needle is used in the facial region to reach the exit point of the nerve from the skull. After entering through this area, the pain is relieved using balloon inflation (compression) or radiofrequency method. In other words, the trigeminal nerve ganglion is desensitized. In the open microsurgical approach, a window is opened in the skull behind the ear to reach the point where the nerve exits the brainstem, and the nerve is moved away from the surrounding blood vessel causing compression. The pressure exerted by the blood vessel on the nerve is relieved."

Pain becomes unbearable

Neurosurgeon Prof. Dr. Pulat Akın Sabancı states: "In Trigeminal Neuralgia, the intensity and frequency of pain attacks tend to increase over time. The lack of appropriate treatment or delayed treatment of pain exposes the person to increasingly worsening bothersome nerve pain in the long term. The longer appropriate treatment is delayed, experiencing this level of pain every day carries a considerable emotional burden for the patient. Patients experiencing this type of continuous pain and not receiving appropriate treatment may develop major depression and suicidal tendencies. Additionally, it should not be forgotten that MS-group diseases and brain tumors can also cause trigeminal neuralgia. It should be considered that if patients with Trigeminal Neuralgia do not seek medical care, causes such as MS or brain tumors may be missed, and intervention in these life-threatening diseases requiring treatment may be delayed or not performed" he concluded.