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Trigeminal neuralgia is usually caused by an intracranial artery or, a venous loop that compresses the Trigeminal nerve at its root entry zone into the brain stem.
Other less common trigeminal neuralgia causes include compression by a tumor and occasionally a multiple sclerosis plaque at the root entry zone, but these are distinguished usually by accompanying sensory and other deficits.
The mechanism is suggested to be a nerve compression which causes local demyelination, which may result in ectopic impulse generation and/or disinhibition of central pain pathways involving the spinal trigeminal nucleus.
Trigeminal neuralgia pain is often precipitated by stimulating a facial trigger point (eg. by chewing, brushing the teeth, or smiling). Sleeping on that side of the face is often intolerable.
- Pain occurs along the distribution of one or more sensory divisions of the trigeminal nerve, most often the maxillary (upper jaw).
- The pain is paroxysmal (spastic), lasting seconds up to 2 min, but attacks may recur rapidly.
- It is lancinating, excruciating, and sometimes incapacitating.
Trigeminal neuralgia symptoms are almost pathognomonic. Neurologic examination is normal in trigeminal neuralgia. Thus, neurologic deficits (usually loss of facial sensation) suggest that the TN-like pain is caused by another disorder (e.g. tumor, stroke, multiple sclerosis plaque, vascular malformation, other lesions) that compress the trigeminal nerve or disrupt its brain stem pathways.
Drugs – Usually anticonvulsants or painkillers that may become ineffective with disease progression and carry various adverse effects.
Surgical intervention – If pain is severe despite the pharmacologic treatment, a surgical treatments are considered; however, efficacy may be temporary, and improvement may be followed by recurrent pain that is more severe than the preceding episodes.
The PainShield® therapeutic ultrasound was demonstrated, in several studies, to reduce pain and help nerve recovery. Unlike conventional bulk wave ultrasound, the PainShield®’s unique frequency and intensity allow for long treatment sessions (6 hours daily) that are more effective than the conventional products.
PainShield® unique advantages over existing treatment alternatives:
- Treating trigeminal neuralgia with the PainShield® allows reduction in medication dosage and eliminates related adverse drug effects.
- The PainShield® patch is applied on a bony surface in the face allowing the surface acoustic ultrasound waves to travel across the entire skull and reach the root of the trigeminal nerve to promote healing of nerve origin (currently under clinical research).
- No limitation in treatment duration.
- The treatment may help avoiding Trigeminal Neuralgia surgery.
Treatment can take place anytime and anywhere even during overnight sleep.
Dr. Adahan, Head pain rehabilitation, Sheba Medical Center
73% of the subjects experienced complete or near complete pain relief. In nearly all cases, there was a delay of 1-2 weeks before the onset of relief followed by a gradual improvement, in pain relief, over the following 2-6 weeks.