What is the difference between typical and atypical trigeminal neuralgia

It can be more difficult to diagnose TN2, as it mimics the symptoms of many other conditions. Neurologists will use the same reference points as those listed above for TN1 but may also need to delve a little deeper.

TN2 is often associated with a lesion or tumor; the degenerative effects of multiple sclerosis can lead to this condition. As with TN1, an MRI can show if there is a lesion on or near the trigeminal nerve or other damage that may be causing the symptoms.

Although both types of trigeminal neuralgia originate at the trigeminal nerve, they usually require different treatments for sufferers to achieve some level of relief. Your doctor can help you determine which treatment is best for your condition. Medical management of TN1 is usually the first thing that will be tried to alleviate the associated symptoms.

The anticonvulsant medications carbamazepine and oxcarbazepine have proven to be the most effective. Microvascular decompression is the first non-pharmaceutical consideration when TN1 is related to nerve impingement from a blood vessel. It is a procedure in which the surgeon places tiny Teflon pads between the nerve and artery or vein, creating a buffer that keeps the impact of the blood vessel from irritating the nerve and causing it to malfunction.

Recovery from MVD is not particularly long in comparison to most intracranial surgeries. Most people resume their normal activities after eight weeks. This completely non-invasive treatment involves the use of tiny beams of radiation focused on a small area. It is especially helpful in cases in which the patient cannot withstand general anesthesia. Recovery from Gamma Knife Radiosurgery is fairly short compared to other treatments. Most people are back to their normal routines in about a week.

Pain Stimulator Placement is another option for those suffering from TN1. In some cases, your neurosurgeon may recommend it over other treatments. Pain stimulators involve threading electrodes under the skin and to the trigeminal nerve. Vascular compression, as described above in typical TN, is thought to be the cause of many cases of atypical TN.

Some believe atypical TN is due to vascular compression upon a specific part of the trigeminal nerve the portio minor , while others theorize that atypical TN represents a more severe form or progression of typical TN. It is also important to note that rhizotomy procedures may be effective in treating atypical TN, but are more likely to be complicated by annoying or even painful numbness i.

Pre-Trigeminal Neuralgia. Days to years before the first attack of TN pain, some sufferers experience odd sensations in the trigeminal distributions destined to become affected by TN. These odd sensations of pain, such as a toothache or discomfort like "pins and needles", parasthesia , may be symptoms of pre-trigeminal neuralgia. Pre-TN is most effectively treated with medical therapy used for typical TN.

When the first attack of true TN occurs, it is very distinct from pre-TN symptoms. Multiple Sclerosis-Related Trigeminal Neuralgia.

Those with MS-related TN tend to be younger when they experience their first attack of pain, and the pain progresses over a shorter amount of time than in those with typical TN. Furthermore, bilateral TN is more commonly seen in people with multiple sclerosis. MS involv es the formation of demyelinating plaques within the brain. When these areas of injury involve the trigeminal nerve system , TN may develop. Trigeminal rhizotomies are employed when medications fail to control the pain. In such cases, microvascular decompression surgery may be considered for treating the MS-related TN.

Secondary or Tumor Related Trigeminal Neuralgia. Trigeminal neuralgia pain caused by a lesion, such as a tumor, is referred to as secondary trigeminal neuralgia. Medications usually help control secondary TN pain when first tried, although often become. Trigeminal neuralgia is usually categorized as typical or atypical, with symptoms differing depending on the type: Typical: With typical TN, the most common form, patients suffer from unpredictable episodes of stabbing, electric shock-like pain in a consistent location.

Atypical: Patients with atypical TN experience a persistent dull ache or burning sensation in one part of the face. However, episodes of sharp pain can complicate atypical TN.