Trigeminal Neuralgia
Trigeminal neuralgia refers to lancinating pain in the 2nd and 3rd divisions of the trigeminal nerve, which is the 5th cranial nerve. It usually occurs in patients over 50 years of age. The exact mechanism of the disease is not known. It is thought to be caused by vascular compression i.e. an aberrant loop of the cerebellar arteries compressing the trigeminal nerve as it enters the brain. Patients usually present with a severe, repetitive, knife-like pain on the face. The pain can be triggered by touching the face, eating, cold wind blowing on the face, and by pronouncing certain words. Diagnosis is mainly clinical. Carbamazepine is mostly prescribed to the patients for treatment. Surgical options include injection of alcohol or phenol into the peripheral branch of the nerve and surgical decompression of the nerve through a posterior craniotomy approach.