When we were oh so very young, our fear was of the monster lying in wait under our bed. We had a foreboding sense that the monster would come out from under the bed and do Lord knew what to us. But whatever was going to happen, we knew it certainly wasn’t going to be good for us.
Then one day Mom dusted under our bed and collected all those dust bunnies. She told us it was what was left of the monster and swept them away. Most believed and nevermore had to worry about the monster again. If anything, most then worried about the bully at school.
What we didn’t know was that for some of us, something to fear wasn’t swept away forever. Now we have a new, well-founded fear. Now it isn’t some imaged monster under the bed but rather an all too real one called trigeminal neuralgia (TN).
It is, as the name implies, an irritation of the trigeminal nerve which wends its way through each side of our face. Often, over the years the protective coating (myelin) of the nerve is worn away. With TN it can happen next to a pulsating artery. That creates one set of conditions for TN. The artery touches the bare nerve and sets it off. If you have ever had an abscessed tooth you have a sense of one form of the continuing pain. In days long ago the pain was uncontrolled which led to TN’s other name – the suicide disease. That was the only way to escape the monster back then.
The disorder is characterized by episodes of intense facial pain that last from a few seconds to several minutes or hours. The facial pain it creates can be unbearable. It can be triggered by common activities such as showering (water spraying against the face), eating, talking, shaving or brushing teeth. Wind, high pitched sounds, loud noises such as concerts or crowds, and talking can aggravate the condition in many sufferers. The attacks are said by those affected to feel like stabbing electric shocks, severe burning, or exploding/shooting pain that becomes intractable (so very true).
The problem is that for each type, regardless of cause, it is impossible to convey with complete understanding the degree of pain that one must bear. Empathy simply doesn’t cut it. Consequently, I for one don’t condemn the reader for not truly understanding precisely how that pain can affect the body and one’s style of living.
But that said, for some sufferers drugs such as gabapentin, baclofen and carbamazepine helps control the pain. If uncontrolled with those medicines, many neurosurgeons can perform a microvascular decompression surgery (entering the skull from behind the ear, locating the affected nerve and artery, then placing Teflon pads between the two). That surgery seems to provide the longest relief from pain. Other techniques include radiofrequency thermorhizotomy and gamma knife radiosurgery; however the effectiveness of these decreases with time. At least for patients taking advantage of these procedures they banish the monster at least for a while.
Unfortunately some who undergo the most drastic procedures find that with time the intense pain recurs. For some others, neither procedures nor medicines mitigate the pain. For them either the monster returns or never leaves from under the bed in spite of Mom’s dusting. For them it is more meds for what little pain relief they give. For them it isn’t sugarplums dancing in their heads but rather ancient cures.