The Silent Tormentor: Understanding Trigeminal Neuralgia

26 March 2024

Imagine a pain that is so unbearable that it can drive someone to consider ending their own life.

Trigeminal Neuralgia, also known as the “suicide disease” or Tic douloureux, is a rare and agonising condition that can severely disrupt one’s life if left untreated.

Despite its low occurrence, it affects individuals worldwide, including celebrities like George Clooney and Salma Hayek.

This silent tormentor presents a complex journey from diagnosis to treatment. However, once accurately diagnosed, it can be effectively treated, changing the lives of those who are silently suffering.

Dr Syed Abdullah Al-Haddad, consultant neurosurgeon at Sunway Medical Centre, helps uncover the aspects of this silent tormentor that may be often overlooked and misunderstood. 

Characteristics Of Trigeminal Neuralgia

The disease is characterised as sudden, intense, stabbing, or electric shock like pain located in the jaw or face that is recurrent or brief, lasting from a few seconds to several minutes and could occur from a few to hundreds of attacks a day.

The disease is also more prevalent among women.

“The intense, electric shock-like one-sided facial pain characteristic of this condition often leads to misinterpretation and misdiagnosis.

“Patients endure years of debilitating pain with one patient describing it as worse than labour pain. Sometimes, patients are bounced from pillar to post, seeking a solution.

“Based on my experience, most of my patients who are referred to me and diagnosed have lived with this pain for an undesirable amount of time with one patient having one whole side of his teeth taken out due to a misdiagnosis as dental pain before being diagnosed with Trigeminal Neuralgia,” explained Dr Syed Abdullah.

The disease also has a profound impact on patients’ lives, including difficulty with daily activities like eating and talking as well as on their mental health and relationships with their loved ones.

“Trigeminal Neuralgia knows no bounds, striking individuals While it tends to afflict those aged 40 to 50, it not only affects physical well-being but also takes a toll on mental health and quality of life.

“As they endure the intense pain, some patients decide to stop talking or even living a normal life. The symptoms can also interfere with their ability to work, impact relationships as some believe that sufferers are ‘mad’ or exaggerating their pain and lead to depression and sleep problems,” added Dr Syed Abdullah.

Easily Diagnosed and Treated, Yet Often Misdiagnosed: Diagnosis And Risk Factors Of Trigeminal Neuralgia

It is also diagnosed through a combination of patient-reported symptoms and a thorough physical examination and a magnetic resonance imaging (MRI) scan to rule out other potential causes such as multiple sclerosis or tumours.

The pain often described by patients is crucial and can be a sign of the disease.

Treatment options for the disease include medication to block pain signals or surgical methods such as stereotactic radiosurgery, a non-invasive procedure that delivers focused radiation to the trigeminal nerve root, reducing pain signals with a shorter recovery time and surgery to relieve pressure on the trigeminal nerve.

“The biggest challenge for patients with this disease is an accurate diagnosis. Frequently, the condition is misdiagnosed as dental problems or issues related to the ear, nose, and throat first.

“This is why it is crucial to listen to the patient’s symptoms and understand the characteristic features of the pain.

“Once the patient is diagnosed, there are many treatment options that range from oral or injectable medications to more invasive procedures such as Gamma Knife Surgery depending on the patients’ needs and limitations as well as the doctor’s recommendation which can bring immense relief to the patient,” said Dr Syed Abdullah.

Building Awareness And Providing Solutions

It is crucial to raise awareness and educate health care professionals and the public about Trigeminal Neuralgia.

By increasing early detection and treatment outcomes, we can ensure that no individual suffers in silence for an extended period and provides effective life changing solutions for them. 

“Building awareness and educating both health care professionals and the public is crucial in improving early detection and treatment outcomes.

“With Trigeminal Neuralgia often being misdiagnosed, it is important for rare diseases such as this one to not only be in the minds of neurologists but all health care professionals from general physicians, dental, ENT surgeons to the public alike so these patients can get the help they need and do not need to suffer any longer in silence,” said Dr Syed Abdullah. 

Source: Ova

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