Left Side Face Pain Do you sometimes experience sudden sharp or shooting pain on one side of the face? It could be a nerve disorder called trigeminal neuralgia. Starting with mild twinges of facial pain, it can lead to more episodes of pain lasting a few hours and days.
“If trigeminal neuralgia is left untreated, even basic activities such as shaving, washing your face and brushing your teeth could cause excruciating facial pain,” says Dr Tan Kian Hian, Senior Advisory, Department of Anesthesiology and Manager, Pain Management Center, Singapore General Hospital (SGH), a member of the Sing Health group.
Trigeminal neuralgia tends to affect older people in their 60s and 70s, particularly women over age 50.
What is Trigeminal Neuralgia?
Trigeminal neuralgia may be due to an artery or blood vessel pressing on the trigeminal nerve — the largest cranial nerve located at the base of the brain. The trigeminal nerve controls sensations in the face and the muscles used in chewing, eating and talking.
What Causes Trigeminal Neuralgia?
The precise cause remains unknown. However, certain conditions such as multiple sclerosis or even a tumour pressing on the trigeminal nerve may trigger the electrical shock-like pain associated with trigeminal neuralgia.
Symptoms of Trigeminal Neuralgia
Facial pain Brought on by trigeminal neuralgia may take Unique forms:
- Occasional moderate pain in regions controlled by the trigeminal nerve – the cheeks, gums, teeth, lips and limbs
- Spontaneous outbursts of pain triggered by mild facial stimulation such as chewing or shaving or an easy touch
- Bouts of radiating facial pain lasting several seconds to several minutes
- Longer episodes of pain strikes lasting days, weeks or months
How is Trigeminal Neuralgia Diagnosed?
A neurological examination will be conducted to identify areas of facial pain. Talk with your physician about the seriousness, duration, frequency and location of the facial pain.
A MRI scan may be necessary to diagnose multiple sclerosis and other medical causes.
Treatment for Trigeminal Neuralgia
Patients may believe that their lives have spun out of control due to the debilitating facial pain, but trigeminal neuralgia is not life-threatening. There are nonsurgical and surgical treatment options available to help patients handle the pain, says Dr Tan.
Pain Relief Medications
Over-the-counter pain relief medicines such as ibuprofen and paracetamol can be ineffective in treating trigeminal neuralgia.
Doctors can prescribe anticoagulant drugs such as carpetbagging (Tegretol) to reduce facial pain and also prevent pain signals from reaching the brain.
If, despite increased dosage, the anticoagulant medications don’t provide any pain relief, doctors may recommend radio frequency lesion (to destroy nerve fibers using electrical current) or neurosurgery.
Neurosurgical Options to relieve Facial Pain
The objective of the neurosurgical procedures would be to eliminate the compressing blood vessel or cause moderate damage to the trigeminal nerve in order it can’t send pain signals to the brain.
Associate Professor N Wei Hoe, Senior Consultant and Head, Department of Neurosurgery, National Neuroscience Institute (NNI), a part of this Sing Health group, describes the three main neurosurgical procedures for trigeminal neuralgia.
Micro Vascular Decompression
This surgery eliminates facial pain by dividing or deflecting the blood vessel compressing the trigeminal root. Because the incision is made behind the ear to the face of the pain, there’s a small risk of decreased hearing and facial weakness.
This painless process uses focused radiation to create mild damage to the root of the trigeminal nerve, which can remove facial pain altogether.
This process involves cutting a part of the trigeminal nervewracking, but it will lead to permanent facial numbness.
Caring for family members with trigeminal neuralgia may be challenging. Patients cannot eat, smile, laugh or talk normally as a result of facial pain. Be patient, inviting and see for any signs of depression, adds Dr Tan.