Why Trigeminal Neuralgia is called the suicide disease and how its pain becomes unbearable
suicide
disease' because of the unbearable intensity of facial pain and its devastating impact on mental health.
While rare, it's frequently misdiagnosed, leaving many to suffer unnecessarily.
Understanding the symptoms, causes, diagnosis, and available treatments is key to improving quality of life for those affected.
What is Trigeminal Neuralgia and who gets it?
Trigeminal neuralgia is a chronic pain condition affecting the trigeminal nerve, a large facial nerve with three branches that send sensation to the forehead, cheek, and jaw. Pain can affect one or more branches and is typically one-sided, though in rare cases, both sides may be involved (bilateral TN).
The condition is most common in people over the age of 50, although it can occur at any age. It's estimated that around 150,000 new cases are diagnosed each year in the United States alone.
The pain of Trigeminal Neuralgia: More than just a headache
The hallmark
symptom
is intense, electric shock-like facial pain triggered by seemingly harmless actions: touching your face, brushing your teeth, eating, or even feeling a breeze. The pain may be:
TN1 (Type 1): Sudden, stabbing or burning pain lasting seconds to minutes
TN2 (Type 2): Constant, aching or throbbing pain with less intensity but longer duration
These attacks often come in cycles, with pain-free periods that may grow shorter over time.
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As the condition progresses, pain can become more frequent and resistant to medication. People with TN often withdraw socially, struggle to eat or speak, and experience anxiety, depression, or suicidal thoughts due to the ongoing pain and its unpredictability.
What causes Trigeminal Neuralgia?
The most common cause is compression of the trigeminal nerve by a blood vessel near its origin in the brainstem. This pressure damages the protective myelin sheath around the nerve, causing it to misfire and send pain signals unnecessarily.
Other potential causes include:
Multiple sclerosis
Herpes zoster (shingles)
Scleroderma and lupus (autoimmune conditions)
Tumours pressing on the nerve
Nerve injury from trauma or dental procedures
In many cases, especially when no clear cause is found, the condition is thought to be linked to nerve degeneration or age-related changes.
How Trigeminal Neuralgia is diagnosed: Ruling out other causes
Diagnosing TN can be challenging because many other conditions—like migraines, sinus infections, or temporomandibular joint disorders (TMJ)—also cause facial pain. There is no single test to confirm TN.
Doctors typically perform a neurological exam, ask detailed questions about your symptoms, and use imaging such as MRI to rule out tumours or multiple sclerosis.
A positive response to anti-seizure medications like carbamazepine may also support the diagnosis.
Treating Trigeminal Neuralgia: From medications to surgery
Managing trigeminal neuralgia (TN) usually starts with medication. Anticonvulsants like carbamazepine, gabapentin, or pregabalin can calm overactive nerves, while tricyclic antidepressants may help with ongoing, aching pain.
If medications stop working or cause side effects, surgical options may be considered.
Minimally invasive procedures like balloon compression, glycerol injections, and radiofrequency ablation aim to block pain signals.
More advanced
treatments
include Gamma Knife radiosurgery, which targets the nerve with focused radiation, and microvascular decompression, which relieves pressure from blood vessels pressing on the nerve. Treatment plans are tailored to each person's symptoms and overall health.
Natural therapies and support: Finding relief from trigeminal neuralgia pain
Although there is no known cure for trigeminal neuralgia, many people find meaningful relief through a combination of medical treatment and natural or complementary therapies.
Options like acupuncture, mindfulness meditation, biofeedback, and physical therapy can help reduce the severity or frequency of painful episodes and support overall emotional wellbeing. While these approaches don't replace medications or surgical interventions, they can be valuable tools in a comprehensive pain management plan.
Living with trigeminal neuralgia can be emotionally and physically exhausting, but you don't have to suffer in silence. If you're experiencing intense or unexplained facial pain, it's essential to consult a neurologist or pain specialist. With timely diagnosis, personalised treatment, and the right support, many people are able to manage their symptoms and improve their quality of life. Despite its grim nickname, the 'suicide disease,' help is available, and recovery is possible.
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