In this video Prof. Dr. A. F. M. Momtazul Haque talks about two conditions caused by a blood vessel pressing on a nerve: trigeminal neuralgia and hemifacial spasm.
What is trigeminal neuralgia?
“Neuralgia” means nerve pain. Trigeminal neuralgia is a very severe, stabbing, electric-shock-like (lancinating) pain in the face. The trigeminal nerve — the fifth cranial nerve, with three branches — supplies the teeth and the side of the face. When a blood vessel keeps pressing on the nerve where it leaves the brain, the nerve “short-circuits” and causes intense pain that spreads towards the teeth.
Why it is often missed
Because the pain is felt in the teeth, many patients go to a dentist first. If a tooth has a little decay, it gets blamed, and the patient may have one dental treatment after another without improvement — before finally reaching a neurologist or neurosurgeon.
Treatment
- Medicine first: drugs such as carbamazepine (Tegretol) usually control the pain for a while.
- MRI: when even the maximum dose no longer works, an MRI shows where and how much the vessel is pressing on the nerve.
- Microvascular decompression (MVD): through a small opening behind the ear, the surgeon uses a microscope to move the vessel away from the nerve and places a small Teflon pad between them. In 90–95% of patients the pain goes away completely.
Hemifacial spasm
In hemifacial spasm one side of the face twitches and the eyelid keeps closing. There is no pain, but it affects vision and is socially embarrassing. Here the facial nerve (the seventh cranial nerve) is compressed by a vessel, and the same microvascular decompression operation cures it.
If you have severe facial pain or one-sided facial twitching that has been diagnosed as trigeminal neuralgia or hemifacial spasm, surgery is a very good option.
This article is for general awareness only; it is not a substitute for direct medical advice.
