Rare Symptoms of MS: 12 Things to Know About Trigeminal Neuralgia
Trigeminal neuralgia is a term used for facial pain associated with damage to the trigeminal nerve, or the 5th cranial nerve — the largest one among the body’s 12 pairs of cranial nerves and one of the most widely distributed nerves in the head.
A list of 12 facts about trigeminal neuralgia, described here, provide further information about this rare MS symptom:
- There are two trigeminal nerves, one on each side of the face. Each nerve has three main branches: the upper or ophthalmic branch, which reaches to most of the scalp, forehead, and front of the head; the middle or maxillary branch that stimulates the nose, cheeks and upper jaw, top lip, teeth, and gums; and the lower or mandibular branch, which reaches the lower jaw and bottom lip, as well as the teeth and gums.
- Damage to the myelin sheath or protective coating shielding the trigeminal nerve is what causes pain in MS. Having a blood vessel pressing on the nerve inside the skull also can result in trigeminal neuralgia and has been occasionally reported in MS patients.
- Trigeminal nerve pain may be triggered by everyday activities such as eating, brushing teeth, washing the face, talking, head movements, air conditioning, breeze/wind exposure, or hot or cold food. It also may come up spontaneously without a trigger.
- Pain can last for a few seconds to up to a few minutes. For some, pain is constant.
- Some report pain like an electric shock, whereas others report an aching or burning sensation.
- Trigeminal neuralgia usually only affects one side of the face, but in rare cases, both sides can be affected at different times.
- Pain can range from mild to excruciating.
- Trigeminal neuralgia can sometimes be mistaken for dental pain or eye pain; thus one should visit a healthcare specialist to determine if the pain is a symptom of MS before considering dental or eye procedures.
- Over-the-counter pain medications — such as paracetamol, aspirin, or ibuprofen — are not effective treatments for trigeminal neuralgia pain.
- The condition often is treated initially with carbamazepine, an anticonvulsant or anti-epileptic medicine that can be used for nerve pain. The muscle relaxant Baclofen also may be given to help relax the muscles.
- If medication is ineffective or causes significant side effects, surgery may be required to deliberately injure the trigeminal nerve so that it stops sending pain signals.
- It is estimated that 4–6% of people with MS experience trigeminal neuralgia.
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