Are there different kinds of trigeminal neuralgia?

Shari Green
Dental Hygiene
Trigeminal neuralgia, a chronic pain condition related to the fifth cranial nerve, can be extremely debilitating. The three branches of the trigeminal nerve innervate the forehead/eyes, the cheek, and the jaw. Trigeminal neuralgia is often experienced in these areas and may be triggered by something as simple as toothbrushing, cold air, wind, laughing, chewing, or light contact to the face. Traditional trigeminal neuralgia and bilateral neuralgia (effects both sides of the face) are possible. Trigeminal neuralgia usually begins on one side of the face, and then can ultimately involve both sides of the face in approx. 5% of the population. Physicians and dentists utilize a variety of modalities to help the patient manage these issues.

Trigeminal neuralgia does come in various types. The classic type involves a sharp shooting episode of electric-shock-like pain, with no pain in between the episodes, triggered by touching areas of the face or eating or chewing. This pain is reliably relieved by one of the medications, usually Tegretol. If the pain is of that sort, then that's the sort of pain that is reliably relieved by microvascular decompression (MVD).

The second type of trigeminal neuralgia can have a more constant aching component that can be there all the time in addition to the sharp shooting episodes of pain. It responds less well to Tegretol; there may be no periods when there is no pain. This type of trigeminal neuralgia can also respond to MVD, but it doesn’t respond as reliably. The success rate may be 85 or 90-plus percent for MVD in the classic sharp shooting episodes. The success rate for this second type of trigeminal neuralgia with a more constant pain component is really only about 50/50.

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