Trigeminal neuralgia is clinically classified into primary and secondary types. The exact cause of primary trigeminal neuralgia is unclear, but it may be due to compression of the trigeminal nerve root, often caused by twisting and compressing the nerve, potentially leading to demyelination and pain attacks. Secondary trigeminal neuralgia generally has a clear cause. Common causes include tumors of the skull base or cerebellopontine angle, metastatic tumors, and meningitis. Brainstem infarction and multiple sclerosis can also cause it. Secondary trigeminal neuralgia is primarily caused by invasion of the sensory root of the trigeminal nerve or by pain attacks originating from internal sensory nuclei. Most cases may also present with other corresponding symptoms and signs, such as sensory disturbances or motor dysfunction in the limbs.
Trigeminal neuralgia
Trigeminal neuralgia. Most cases are primary neuralgia, mainly manifesting as pain in the distribution area of the trigeminal nerve. The pain is generally episodic and short-lived, usually lasting from a few seconds to 1-2 minutes, and can stop abruptly or recur repeatedly. Treatment primarily involves symptomatic pain relief, such as oral carbamazepine, carbazepine, or sodium benzoate. Neurotrophic drugs such as vitamins (B1, B6, adenosylcobalamin, and methylcobalamin) can also be used. The trigeminal nerve includes the ophthalmic, maxillary, and mandibular branches. Ocular lesions generally manifest as periorbital and forehead pain; maxillary branch lesions mainly manifest as pain in the maxilla; mandibular branch lesions mainly manifest as pain in the mandible; toothache may also occur, and sometimes postauricular pain.
What medications are used to treat trigeminal neuralgia?
Trigeminal neuralgia can be treated with carbamazepine, phenytoin sodium, oxcarbazepine, or neurotrophic drugs such as vitamin B1, vitamin B6, adenosylcobalamin, and methylcobalamin. The trigeminal nerve includes the maxillary, mandibular, and ophthalmic branches. Lesions of the ophthalmic branch mainly manifest as pain in the eye and forehead, while lesions of the maxillary and mandibular branches manifest as pain in the upper or lower jaw. Some people may also experience pain behind the ear or toothache. Generally, the pain lasts from a few seconds to 1 to 2 minutes and can stop suddenly or recur repeatedly.