More popularly called Trigeminal Neuralgia, tic douloureux is a condition where sudden jabs of pain are felt in the face. When they start, the attacks are mild and short, but as the condition progresses, the pain becomes more searing and longer. Tic douloureux can affect the eyes, lips, scalp, forehead, nose, and upper and lower jaw. If you have this condition, and you want it to stop completely, there are several effective tactics you can try.
Medications
This is the first option patients turn to when tic douloureux occurs. The only disadvantage is, people can develop unpleasant side effects or resistance to these medicines when they're used too frequently.
- Antipasticity agents - These work to relax the muscles. One example is baclofen, which can be used with phenytoin or carbamazepine, or just by itself. Some side effects are drowsiness, confusion and nausea.
- Anticonvulsants - Some types include phenytoin, carbamazepine, lamotrigine, oxcarbazepine, and gabapentin. Your physician can advice you to switch to another type or increase the dosage if the type you're using is losing its effectiveness. This type of medication can affect your moods negatively or trigger a drug reaction.
- Opiates - Morphine and oxycodone are prescribed, but only as a last resort, and only when they are proven effective against the neuropathic pain.
Surgical Procedures
A number of surgical procedures are available for treating tic douloureux. The goal is to either damage the nerve or stop the blood pressure from compressing it. Here are some examples of procedures.
- Electric current - The treatment is known as PSRTR or Percutaneous stereotactic radiofrequency thermal rhizotomy, and works to destroy the nerve fibers that causes pain. The doctor puts hollow needle through your face and into an opening in the skull. Once in proper position, an electrode is threaded through it and goes to your nerve root. After you've figured where the tingling sensations are, the surgeon locates the nerves involved, you are sedated again, then the electrode is heated and damages the nerve fibers. Facial numbness if felt after this procedure.
- Nerve severance - Called partial sensory rhizotomy, this method cuts part of the trigeminal nerve, just at your brain's base. Through an incision made behind the ear, a quarter-sized hole is made to go through your skull. Since the nerve is cut at the source, your face becomes numb permanently.
- Radiation - A focused and high dosage of radiation is delivered to the trigeminal nerve root, damaging the nerve and eliminating or reducing the pain. There's relief gradually, but it can take a few weeks before you feel it. This process is painless.
- Microvascular decompression or MVD - This works by relocating and removing blood vessels that are in contact with the trigeminal root, separating them. An incision is made behind the ear where you feel the pain. Afterwards, a part of your brain is lifted, so the trigeminal nerve is seen. If there's no vein or artery compressing the nerve, the surgeon severs it. If there is, the surgeon directs the artery in contact, or places a pad in between the two.
- Balloon Compression - A small balloon catheter is placed through the needle and in the nerve at the base of the skull. The balloon is inflated briefly, to compress the nerve and damage it, blocking pain signals. Facial numbness is felt by people who go through this, while some feel loss of strength in the muscles they use for chewing.
Injections
Some substances can be inserted in the nerve, to lessen the pain. Although the effects are not as permanent, these are very effective in giving relief.
- Botox - Injected in the nerve and is said to have positive results among many patients.
- Alcohol - This is a temporary pain relief for tic douloureux, working by numbing the affected parts of your face. The doctor injects alcohol according to the trigeminal nerve branch that is causing pain. Since this isn't permanent, you may need repeated injections or another treatment option in the future.
- Glycerol - Inserted in the gasserian ganglion as a simple and effective solution. An intravenous needle is placed in the nerve in the skull's base and glycerol is injected.
Avoiding Pain
- Be aware of the trigger factors of tic douloureux. Gargling, cold water and some facial movements may cause pain.
- Don't expose your face to wind or cold drafts. At night, make sure the room temperature isn't very low.
- Avoid mental and physical stress. Long drives, anxiety and lack of sleep are prohibited.
- Avoid too much stress on your facial muscles. Eating hard food items or sudden jerky movements are not advisable.
- Practice good oral hygiene. This promotes oral health and avoids dental carries.
Tic douloureux can be solved with the help of these treatment options. One las tip: learn to relax. The more stressed out you are, the more likely it is for the condition will worsen.
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