Salamat Dok: Trigeminal Neuralgia - The suicide disease

By Yam dela Cruz, Multimedia producer, Salamat Dok

Posted at Oct 30 2011 06:31 PM | Updated as of Nov 03 2011 08:42 PM

Not all severe pains are related to cancer. There are medical conditions which are not much talked about but have the torturing facial pain symptom. Let us introduce you to Trigeminal Neuraglia (TN) -- a neuropathic disorder. Here’s a story.

Case Study

It was 2008 when Hazel felt pains in her left cheek while washing her face. She thought it was a dental problem so she went to a dentist but her X-ray showed negative results. The pain didn’t go away and she was surprised that over-the-counter pain relievers didn’t work.

“One time, I woke up at dawn due to an indescribable pain. It lasted for 10 seconds. I called a doctor and I was referred to a Neurologist. The diagnosis is Mild Trigeminal Neuragla but the cause is not identified,” narrates Hazel.

She was given oral medications which she’s been using until now as maintenance. “It affected me every more because I don’t know when it’s going to attack again. Can you imagine even brushing teeth is controlled? There are times when I can even open my mouth,” adds Hazel.

Hazel’s condition depresses her at times. She’s traumatized by experiencing torturing pain.

What is Trigeminal Neuralgia?

Dr. Godfrey Robeniol, Neurology Consultant at the UP-Philippine General Hospital says, “Trigeminal Neuralgia’s pain starts in a nerve. We have 12 nerves in the brain. It’s the 5th nerve where TN originates. One of its important functions is to bring what the face feels to the brain and the brain interprets it. That’s the problem with Trigeminal Neuralgia. If the nerve becomes irritable, that brings pain.”

What triggers it?

  • Common daily activities

             o Washing the face
             o Brushing teeth
             o Shaving
             o Talking
             o Eating and chewing

  • Common sensations such as having wind hit your face
  • Swollen or peeling off nerve
  • Trigeminal nerve that is too close to a blood vessel
  • Pressed of squeezed nerve pathway
  • History of head trauma
  • Problem with a part of your brain where trigeminal nerve passes

 How painful it is?

Trigeminal neuralgia is also called the ‘Suicide Disease’. “This kind of pain comes in what we call paroxysm. It’s gusty. You will suddenly feel like being struck by lightning or a sudden stab on your face. It could also be a hot painful feeling. Sometimes it last for just a second, sometimes it lingers for a few minutes,” explains Dr. Robeniol.

Why is it called a suicide disease?

It’s because of the unexplainable excruciating pain. One of the important characteristic of this disorder, when you touch your face or the affected area where the pain originates, it produces extreme pain even when you toothbrush, eat, or chew.
Dr. Robeniol adds, “Even the air blow of electric fan triggers an attack. That’s why others commit suicide to escape from this torturing agony.”

Incidence

4 out of 100, 000

Who are at risk?

This disorder affects women more than men, with ratio of 3 to 2. As to why more women than men are affected is still unexplainable. There’s still a lot of research to do with this disorder.

Treatment

Oral medication such Carbamazepine, an anti-convulsant drug, is being used for epilepsy. TN is not epilepsy but the effect of this drug to calm nerve impulses and it often works well for TN.
“Common pain relievers are anti-inflammatory or muscle relaxant so they don’t address nerve problem that’s why it’s hard to treat it because ordinary analgesics are not effective for this kind of condition,” explains Dr. Robeniol.
Surgical procedures are reserved for patients with intractable pain or to those whose lives are very much affected with Terminal Neuralgia. The surgery costs around 150 to 200, 000 pesos. – with reports by Maila Cuevas and Otek Galauran, Episode October 22, 2011


Salamat Dok is ABS-CBN’s multi-awarded public service and medical talk show that airs live on Saturdays 6am and Sundays 730am, simulcast on ANC. Like us on Facebook https://www.facebook.com/ABSCBNsalamatdok. Follow us on Twitter @salamatdok. Circle us on Google+. Email: [email protected]