A number of causes can be attributed to facial pain, which makes a trigeminal neuralgia diagnosis an often challenging experience. Patient distress, as well as the clinical overlap with general dentistry, can lead to different kind of outcomes before the diagnosis is made. Because of this, close attention needs to be paid to avoid misdiagnosis, especially as one of the symptoms of a neurodegenerative illness.
In those without MS, compression of the trigeminal nerve is a common cause of TN. It is believed to be the pressing of a blood vessel on the trigeminal nerve as it leaves the brainstem, causing the wearing away of the protective coating around the myelin sheath around the nerve. When the nerve fibres short-circuit, electric shock-like pain happens.
People with MS are 20 times more likely to develop TN, of which approx. 20% can experience it on both sides of the face (although rarely at the same time). Compression is unlikely to be the reason in those living with MS, where the cause most likely is a demyelinating scar or plaque.
More rarely, symptoms of TN may be caused by nerve compression from a tumour. Injury to the trigeminal nerve (perhaps the result of sinus surgery, oral surgery, stroke, or facial trauma) may also produce neuropathic facial pain. Continue reading