Recent update on trigeminal neuralgia

Abstract

Trigeminal neuralgia (TN), a long-term disorder affecting the trigeminal nerve, is a form of debilitating neuropathic pain. Although the underlying pathogenesis of TN is debatable, loss of myelin along the trigeminal nerve due to direct compression from a blood vessel or secondary to other conditions such as multiple sclerosis or stroke is thought to be the principal cause. Paroxysmal sporadic pain, with unilateral onset, is the main phenomenon of TN. TN is typically diagnosed clinically. Medications, surgery, and complementary techniques are among the current therapy options for altering the neural circuits associated with TN. Nevertheless, anti-epileptic and tricyclic antidepressant medications are recognized as first-line treatments, and surgical treatment may be required for patients who have not obtained a therapeutic effect with at least three medications, have experienced intolerable side effects, or have symptoms that are not resolving. Stimulation of brain regions is an emerging off-label technique that has the potential to offer pain relief from TN, but sufficient data and more extensive studies on both animals and humans are yet to be published. More specifically, convenient diagnostic techniques and affordable treatment modalities for TN have become crucial needs in order to reduce the psychological and socio-economical losses caused by TN.

Systematic review on the frequency of occurrence in nerve branches and the side of the face involved in trigeminal neuralgia and its clinical implication

“…There are also three types of TN: essential, idiopathic, and classical. Blood vessels compressing the trigeminal nerve root as it enters the brain stem is the cause of nearly all occurrences of trigeminal neuralgia ( 2 ). It has been demonstrated that not all patients with TN had vascular compression, and vice versa.…”

“…It has been demonstrated that not all patients with TN had vascular compression, and vice versa. Although neurovascular compression accounts for most TN cases, primary demyelination disorders, such as multiple sclerosis (MS), can also lead to TN symptoms (2)(3)(4). It is often known that women have trigeminal neuralgia at higher rates than men do (5).…”