Trigeminal neuralgia is a nerve problem that occurs in the face, and the onset of pain has a certain regularity. In the early stage of trigeminal neuralgia, the onset of pain is very short, lasting only a few seconds to a few minutes, and then stops suddenly. In the early stage, the number of attacks is less, the intermission is longer, and there is no discomfort during the intermission (only severe patients may still have persistent mild dull pain during the intermission). After a period of time, it will suddenly occur again. Professor Wang Jing introduced that trigeminal neuralgia can be cured by microvascular decompression.
What are the early symptoms
of trigeminal neuralgia?
1. The symptoms of trigeminal neuralgia are sharp pain caused by cutting, burning, needling or electric shock, which begins suddenly during morbidity. The pain is often so severe that the patient has to stop talking, eating and walking, cover his face with his hands, grind his teeth, rub his face forcefully, and avoid the person who is talking. Face is aglow, masticatory muscle and facial muscle convulsion, reason calls phenomenon of convulsion of painful sex of one side flesh or painful sex convulsion. The pain can disappear suddenly, lasting for a few seconds or minutes, and then stop immediately without any discomfort symptoms. It was completely painless during the second episode.
2. The trigeminal nerve is symmetrically distributed on both sides of the face, with three branches on each side, mainly in charge of the sensation of the face, teeth, cornea, nasal cavity, lips, most of the scalp and meninges, so trigeminal neuralgia occurs in these parts. It is often morbidity of one or more parts of one side of the face, and morbidity of both sides at the same time is rare. In the early stage of morbidity, the distribution of one branch can be concentrated, and it will not change for a long time, mostly in the second branch or the third branch of one side, or in the area between the second and third branches. Then it can gradually spread to other branches. If the pain of the first branch is in the upper eyelid and forehead, the pain of the second branch is in the upper lip, gingiva and cheek, and there is also pain in the hard palate. The pain of the third branch is in the lower lip, gingiva and mandible, involving less pain in the tongue, and occasionally bilateral attacks.
3. When the symptoms of trigeminal neuralgia occur, the affected half of the face of patients with trigeminal neuralgia may show spasmodic distortion. Sympathetic neurosis sometimes occurs after the attack is terminated. The main symptoms of trigeminal neuralgia are that the affected side of the face is white first, then flushed, conjunctival congestion, accompanied by tears, runny nose, salivation and so on. In the late stage of morbidity, conjunctival inflammation and stomatitis may occur. Some patients hold their cheeks with their palms and rub them vigorously in order to relieve the pain. Over time, the facial skin on the affected side becomes rough, thickened, and the eyebrows are sparse or even fall off.
4. The morbidity of trigeminal neuralgia is periodic, some people once a few days, some people once a few weeks and months, and serious trigeminal neuralgia may be dozens of times a day. Some patients often morbidity in a certain season every day, do not attack in this season, and then start to attack again at this time next year.
5. Trigeminal neuralgia morbidity is often affected by the mental and psychological status of patients, if the patient is often in a bad mood, emotional excitement and easy to get angry, the number of morbidity will be more, and the pain will be more intense.
6. Trigger point (trigger point) More than 50% of patients have a special skin sensitive area in a certain area of the face. If there is a slight touch, the pull and vibration of the facial muscles can cause the attack. In this way, the sensitive area is limited and concentrated at one or two points, which is called “trigger point” or “trigger point”. A patient may have several trigger points, which are commonly located in the upper and lower lips, mouth, nose, cheek or gingiva of the affected side. Whenever this point is stimulated and affected, it will cause an attack. From this point, immediately radiate to other parts. Facial stimulation includes talking, singing, eating, washing face, shaving, brushing teeth and blowing.
7. Physical examination of nervous system showed that there were no positive signs of primary trigeminal neuralgia except for the weakening or disappearance of corneal reflex in some patients. A small number of patients, in the late stage of morbidity, mostly due to the use of alcohol blocking and radiofrequency therapy, the sensation in the pain area of the affected side decreased, resulting in partial numbness. In this case, a detailed nervous system examination should be performed to exclude secondary trigeminal neuralgia.
In the early stage of morbidity, the number of pain attacks is less, often after a cold, the interval is as long as several months or years. There are few cases of self-healing. After that, the attack is gradually frequent, the pain is aggravated, and the course of the disease can vary from several years to decades. Severe attacks occur day and night, dozens or even hundreds of times a day, unable to eat and drink water, emaciated, patients are in a state of pain all day long, depressed and painful expression, and even lose confidence in life and commit suicide. Some patients have seasonal attacks in the early stage, and the pain occurs periodically at a certain time in spring or autumn every year, and the duration of each attack varies from 1 to 3 months, and then disappears naturally without any reason. Until the onset of the same season next year.
Drug therapy is the preferred treatment for trigeminal neuralgia, but drug therapy can only relieve the pain and can not achieve the purpose of radical cure. Professor Wang Jing introduced that if patients with trigeminal neuralgia are ineffective through drug therapy, they should be evaluated by surgery as soon as possible. At present, microvascular decompression surgery is the first choice, with a radical cure rate of more than 98%. The operation is safe. Protecting the integrity of the patient’s nervous system is the preferred treatment in neurosurgery at present.
What
are the risks
of microvascular decompression for trigeminal neuralgia? Many cases have been found in the treatment of patients
with trigeminal neuralgia. Many patients with trigeminal neuralgia have taken a large amount of carbamazepine tablets for a long time to relieve the pain, and they are unwilling to use surgical treatment. This situation leads to more and more serious trigeminal neuralgia disease, and more and more patients with trigeminal neuralgia.
At present, the incidence
of trigeminal neuralgia is very high in our country, and it has become a common disease. It has a great impact on the daily life and learning of patients, and now the survey finds that this disease is not only the “patent” of middle-aged and elderly people. There is a trend towards younger people, which causes us to panic.
Therefore, the inhibition of trigeminal neuralgia disease has become a work that can not wait to be completed. Why do so many patients reject surgical treatment? After our survey, many people do not want to take the risk of surgical treatment, on the other hand, they do not want surgery to harm their appearance. Everyone has the heart of beauty, the morbidity of patients with trigeminal neuralgia is generally the left side of the face, if the operation is carried out on the face. For many people, it is no less than “disfigurement”, so this treatment is rejected by everyone.
Suitable population
for microvascular decompression surgery
According to the statistics of all patients who have undergone microvascular decompression surgery, more than 90% of them are elderly people over 50 years old, and few people between 40 and 50 years old have undergone such surgical treatment.
So what exactly is this surgical treatment?
1. First of all, we should make it clear that microvascular decompression surgery is not terrible. What is terrible is that we do not have the right heart to face it.
2. Microvascular decompression surgery is a minimally invasive surgery, which is completed after the patient, through an external incision in the patient’s head. Then the trigeminal nerve and blood vessels of the patient are treated by microscopic technology, so as to achieve the effect of thorough treatment.
3. The risk of microvascular decompression surgery is similar to that of appendicitis surgery, so the risk of surgery that some people worry about does not exist.
4. As long as the patient’s hair grows up after the operation, the minimally invasive incision can hardly be seen.
