Taking the shooting pain away
A patient undergoing microvascular decompression. Pix by Sameera Weerasekera
More than one nerve branch can be affected by the disorder, MediScene learns.
Dr. Liyanage says that the contributory factors are unknown, but there is an assumption that it could be due to neuronal damage caused by the vascular loop as the nerve emerges from the brain stem (pons).
This could be affecting nerve conduction, propagating severe pain.
The prevalence is about 4 cases per 100,000, in those above 40, with a female preponderance.
“Commonly, the maxillary and mandibular branches of the trigeminal nerve are affected,
with the pain pattern being stereotypical (having a sameness) and lasting year after year, making the patient’s life miserable,” he says.
The clinical picture depends on symptoms, as there are no neurological abnormalities. Diagnostic scans, even Magnetic Resonance Imaging (MRI) show nothing, with serological tests being negative.
The pain is paroxysmal (on one side) and comes about without any provocation. The ‘triggers’ include simple and routine actions such as talking, brushing of teeth, shaving, eating or drinking cold stuff or even exposure to wind, MediScene understands.