Trigeminal Neuralgia

Trigeminal neuralgia (TN, or TGN), also known as prosopalgia, tic doloureux, or Fothergill's disease is a neuropathic disorder characterized by episodes of intense pain in the face. It has been described as among the most painful conditions known. The pain originates from a variety of different locations on the face and may be felt in front of the ear, eye, lips, nose, scalp, forehead, cheeks, mouth, or jaw and side of the face. Neuropathic pain is the cardinal sign of injury to the small unmyelinated and thinly myelinated primary afferent fibers that subserve nociception. The pain mechanisms themselves are altered. Microanatomic small and large fiber damage in the nerve, essentially demyelination, commonly observed at its root entry zone (REZ), leads to ephaptic transmission, in which action potentials jump from one fiber to another.A lack of inhibitory inputs from large myelinated nerve fibers plays a role. It is hard to dismiss as insignificant the observations made by numerous neurosurgeons during decompressive surgery that arterial compression of the root at the dorsal root entry zone is the common finding in typical TGN. Similarly, in MS patients suffering from TGN, a common finding is the plaque extending into the dorsal root entry zone.The dorsal root entry zone represents the junction between the peripheral and central myelins of Schwann cells and astrocytes. United Kingdom people around 874,836 among the total population are suffering from this disease that is 2.58% of the population effected.