Content

• Steps
• Advice

Tridental neuralgia is a chronic pain affecting the trigeminal nerve (the largest of the cranial-facial nerves). This illness has symptoms of burning, stabbing sensation and pain scattered in different areas of the face. Trilateral neuropathy is classified into category 1 (TN1) and type 2 (TN2). You can follow these steps to rule out pain symptoms caused by this disease.

Steps

Method 1 of 2: Treat pain with medical methods

1. 

   Ask your doctor about anticonvulsants. Using anticonvulsants is one of the most common treatments for tricyclic neuralgia. Your doctor may prescribe one or more anticonvulsants until you find the one that works best for your symptoms.
   • Often they prescribe anticonvulsants instead of traditional pain relievers (such as nonsteroidal anti-inflammatory drugs) because they are ineffective in blocking the electrical signals from the nerve cells that cause the sensation. pain.
   • Carbamazepine is the first commonly prescribed anticonvulsant.
   • Oxcarbazepine is similar to the drug carbamazepine in effect, easier to tolerate, but more expensive. Gabapentin and lamotrigine are often used in patients who cannot tolerate carbamazepine.
   • Baclofen can be an effective medication to be taken with anticonvulsants, especially when the trigeminal neuralgia is associated with multiple sclerosis.
   • Anticonvulsants will be less effective after a period of use because they accumulate in the blood, at which time the doctor will prescribe another anticonvulsant that the body is not greasy.

2. 

   
   
   Use tricyclic antidepressants. Tricyclic antidepressants are commonly used to treat symptoms of depression, but they are also effective for chronic pain.
   • It can treat some chronic pain conditions, such as atypical facial pain, but is ineffective with classic tricyclic neuralgia.
   • Compared to a dose of depression, doctors usually prescribe a lower dose of tricyclic antidepressants for chronic pain.
   • The popular tricyclic antidepressants for chronic pain include amitriptyline and nortriptyline.

3. 

   
   
   Avoid pain relievers and opioid medications. These drugs are ineffective in the treatment of pain flare-ups in classic trigeminal neuralgia. However, some patients with TN2 disease react to pain relievers and opioids.
   • TN2 has a constant pain symptom that worsens the condition by accumulating a lot in the blood, while TN1 causes repeated pain that cannot be treated with pain relievers or medications. opioid group.
   • The pain relievers and opioid drugs that doctors usually prescribe are allodynia, levorphanol or methadone.

4. 

   
   
   Try an antispasmodic. Antispasmodic agents have analgesic effects caused by the trigeminal nerve, sometimes used in conjunction with anticonvulsants.
   • The reason antispasmodic drugs are used to treat this disease is because they can inhibit muscle involuntary movement because nerve cells mistakenly signal during pain flare.
   • Popular antispasmodic drugs include Pharmaclofen, Prindax and Baclosal, all of which are brand-name drugs of the baclofen group.

5. 

   Ask your doctor about Botox injections. Your doctor may consider Botox injections if you are greasy or unresponsive to anticonvulsants, tricyclic antidepressants, and antispasmodics.
   • Botox has been shown to be highly effective in treating tricyclic neuralgia, especially in cases of jerky muscles.
   • Many people feel uncomfortable thinking about getting Botox injections because it evokes a negative association with how to use Botox in plastic surgery, but you should not underestimate it because it can reduce chronic facial pain. effective after other unsuccessful ways.

6. 

   Consider using unorthodox treatments. Informal treatment options have not been adequately studied to see if it is effective in treating the disease. Despite this, there have been reports that acupuncture and nutritional therapy may reduce pain somewhat. advertisement

Method 2 of 2: Treat pain with surgery

1. 

   Consult about surgery. Tricyclic neuralgia is a disease that progresses over time. While medications can limit the effects of symptoms, severe cases have the potential to cause permanent nerve damage, leading to pain depletion or permanent paralysis of part of the face. You should consider surgery if your medication has not been successful.
   • Your doctor will work with you to choose the best surgery option based on your health and medical history. The severity of the disease, history of peripheral neuropathy and general well-being are factors that influence surgical choice.
   • The overall goal of surgery is to minimize damage to the trigeminal nerve as the disease progresses over time, and to improve quality of life when medications are no longer effective for pain treatment.

2. 

   Ball compression surgery. The purpose of a balloon compress is to slightly injure the branches of the tricuspid nerve so that the pain-carrying pulse cannot propagate.
   • During the procedure, a small balloon-tip catheter is inserted into the heart of a large needle through the skull, then pumped water to inflate the balloon and pressurize the nerve into the skull.
   • This is an outpatient procedure performed under general anesthesia, although sometimes you need to stay in the hospital overnight.
   • Squeezing can treat the pain for two years.
   • Many patients experience temporary facial stiffness or chewing muscle weakness after the procedure, but generally no pain goes away.

3. 

   Ask your doctor about glycerol injections. The injection of glycerol is performed when the disease affects the third and lowest arm of the tricuspid nerve.
   • This outpatient procedure involves inserting a small needle through the cheek into the base of the skull, near the third branch of the nerve.
   • Once injected, glycerol destroys the trigeminal nerve and therefore no longer feels pain.
   • This procedure can treat pain for one to two years.

4. 

   Burning with high frequency waves. High-frequency coagulation is an outpatient procedure that coagulates nerve fibers with an electrode, leaving the affected area no longer feeling.
   • To do this, a needle with the role of an electrode is inserted into the trigeminal nerve.
   • After locating an area where the nerve is causing pain, the doctor inserts a small electrical pulse into the electrode to destroy the nerve tissue, numb the area.
   • Symptoms recur after three to four years in about 50% of patients.

5. 

   Learn techniques of gamma knife surgery. This technique uses images observed from a computer to focus the radiation on the correct tricuspid nerve.
   • Radiation causes damage to the nerves, blocking emotional signals from reaching the brain and thus reducing pain.
   • The patient can go home the same day or be discharged from the hospital the day after.
   • Most patients who undergo gamma knife surgery report no pain after a few weeks or months but that pain will return within three years.

6. 

   Surgical microvascular compression. This is the most invasive of the triple neuralgia treatments. The doctor opens a small hole in the skull behind the ear and then uses an endoscope to look at this nerve, and they place a cushion between the nerve and the blood vessel that is pressing on it.
   • Recovery time varies from person to person, but generally you will need to stay in the hospital.
   • This is the most effective treatment for trigeminal neuralgia. In about 70-80% of patients, pain completely and immediately after surgery, and the effect can last from 10-20 years in 60-70% of patients.

7. 

   Understand a neuralectomy. This procedure requires removal of part of the tripling nerve. This is an invasive procedure and applies only to patients who are resistant to drugs, or who are unable to undergo another surgery.
   • It is common to cut a nerve when it is not possible to find a blood vessel compressing the nerve during the microvascular compressive method.
   • The purpose of surgery is to remove different parts of the branch of the tricuspid nerve to relieve pain.
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Advice

• Symptoms of TN1 (classic tricyclic neuralgia) are sudden onset of pain that last from a few seconds to two minutes. Painful sites are usually on the cheeks or chin, rarely in the forehead.
• TN2 disease (also known as atypical tridental neuralgia) is a case of persistent pain in the face. Atypical trigeminal neuralgia is a completely different condition in which the mechanism of the onset of the disease is much more confusing than the classic tricyclic neuralgia.
• People with TN1 often avoid touching the face to not stimulate muscle spasm. Whereas patients with atypical facial pain have to massage or massage the face. This is the most noticeable difference between the two conditions.