[Disease Science] Introduction to the pain distribution and course of trigeminal neuralgia

Patients with trigeminal neuralgia often describe a special triggering stimulus, such as touching the face or cheeks to stimulate, talking and swallowing, and many patients report that exposure to the cold can also trigger pain. Skin triggers are often induced by non-noxious stimuli and are often confined to the front. The trigger area is often on the same side of the pain, but it can be caused by the same or different branches of the trigeminal nerve. The trigger area is rare outside the trigeminal nerve innervation, and often exists in the upper neck skin. Patients with trigger points on the scalp often refuse to wash or comb their hair. Shaving is impossible for patients with trigger points on the upper lip or face. Patients with trigger points on their teeth or gums cannot perform oral hygiene. When swallowing or chewing triggers pain, it may affect the patient’s eating and drinking. In severe cases, malnutrition or dehydration may occur. Distribution of trigeminal neuralgia pain The pain of most patients with trigeminal neuralgia is limited to the skin area innervated by the trigeminal nerve. A small part of the pain occurs at the same time in the area innervated by the trigeminal nerve, the intermediate nerve (Ⅷ), the glossopharyngeal nerve (IX), and the vagus nerve (X). The most common pain site is the area dominated by the second and third branches of the trigeminal nerve, and the least common is the area dominated by the first and third branches. The cheek is the most common part of trigeminal neuralgia. The pain syndrome can occur in any part of the face and forehead, and all the ways of combining the painful parts have been reported. The course of trigeminal neuralgia is a disease with intermittent episodes. Many cases have reported intermittent periods of months or even years between two episodes. Almost all recurrences are in the same part of the face, but the range of pain tends to expand. Usually the interval between attacks gradually shortens and the severity and frequency of attacks gradually increase. Once the disease appears in some patients, there is no relief. Patients often complain of a small, non-injury tingling in the pain area during severe pain episodes. Physical and psychological stress significantly increases the pain of trigeminal neuralgia patients, but there is no evidence that stress is the cause of the disease.

Introduction of pain distribution and course of trigeminal neuralgia

Patients with trigeminal neuralgia often describe a special triggering stimulus, such as touching the face or cheeks to stimulate, talking and swallowing, and many patients report that exposure to the cold can also trigger pain. Skin triggers are often induced by non-noxious stimuli and are often confined to the front. The trigger area is often on the same side of the pain, but it can be caused by the same or different branches of the trigeminal nerve. The trigger area is rare outside the trigeminal nerve innervation, and often exists in the upper neck skin. Patients with trigger points on the scalp often refuse to wash or comb their hair. Shaving is impossible for patients with trigger points on the upper lip or face. Patients with trigger points on their teeth or gums cannot perform oral hygiene. When swallowing or chewing triggers pain, it may affect the patient’s eating and drinking. In severe cases, malnutrition or dehydration may occur. Distribution of trigeminal neuralgia pain The pain of most patients with trigeminal neuralgia is limited to the skin area innervated by the trigeminal nerve. A small part of the pain occurs at the same time in the area innervated by the trigeminal nerve, the intermediate nerve (Ⅷ), the glossopharyngeal nerve (IX), and the vagus nerve (X). The most common pain site is the area dominated by the second and third branches of the trigeminal nerve, and the least common is the area dominated by the first and third branches. The cheek is the most common part of trigeminal neuralgia. The pain syndrome can occur in any part of the face and forehead, and all the ways of combining the painful parts have been reported. The course of trigeminal neuralgia is a disease with intermittent episodes. Many cases have reported intermittent periods of months or even years between two episodes. Almost all recurrences are in the same part of the face, but the range of pain tends to expand. Usually the interval between attacks gradually shortens and the severity and frequency of attacks gradually increase. Once the disease appears in some patients, there is no relief. Patients often complain of a small, non-injury tingling in the pain area during severe pain episodes. Physical and psychological stress significantly increases the pain of patients with trigeminal neuralgia, but there is no evidence that stress is the cause of the disease.

【Popularization of Disease】Distribution and causes of trigeminal neuralgia pain

Trigeminal neuralgia is a nerve problem that occurs in the face, and the onset of pain has a certain regularity. The onset of pain in the early stage of trigeminal neuralgia is very short, lasting only a few seconds to a few minutes, and then stops suddenly. The number of early onsets is small, the intermittent period is also long, and there is no discomfort during the intermittent period (only severe patients can still There is a continuous mild dull pain), and after a period of time, it will come on suddenly. The trigger area is often on the same side of the pain, but it can be caused by the same or different branches of the trigeminal nerve. The trigger area is rare outside the trigeminal nerve innervation, and often exists in the upper neck skin. Patients with trigger points on the scalp often refuse to wash or comb their hair. Shaving is impossible for patients with trigger points on the upper lip or face. Patients with trigger points on their teeth or gums cannot perform oral hygiene. When swallowing or chewing triggers pain, it may affect the patient’s eating and drinking. In severe cases, malnutrition or dehydration may occur. The distribution of trigeminal neuralgia pain The pain of most patients with trigeminal neuralgia is limited to the skin area innervated by the trigeminal nerve. A small part of the pain occurs at the same time in the trigeminal nerve innervation area and the intermediate nerve (Ⅷ), glossopharyngeal nerve (IX), and vagus nerve (X) innervation area. The most common pain site is the area dominated by the second and third branches of the trigeminal nerve, and the least common is the area dominated by the first and third branches. The cheek is the most common part of trigeminal neuralgia. The pain syndrome can occur in any part of the face and forehead, and all the ways of combining the painful parts have been reported. Sanyou neuralgia is a disease with intermittent episodes. Many cases have reported intermittent periods of months or even years between two episodes. Almost all recurrences are in the same part of the face, but the range of pain tends to expand. Usually the interval between attacks gradually shortens and the severity and frequency of attacks gradually increase. Once the disease appears in some patients, there is no relief. Patients often complain of small, non-invasive tingling pains in the painful area during severe pain episodes. Physical and psychological stress significantly increases the pain of patients with trigeminal neuralgia, but there is no evidence that stress is the cause of the disease.

[Before you know] How to avoid the triggering factors of trigeminal neuralgia?

Patients with trigeminal neuralgia often describe a special triggering stimulus, such as touching the face or cheeks can be stimulated, talking, swallowing can be stimulated, and many patients report that the face is exposed to cold can also trigger pain. Skin triggering is often induced by non-invasive stimuli and is often limited to the front. The trigger area is often on the same side of the pain, but can be caused by the same or different trigeminal nerve branches. Trigger areas outside the innervation of the trigeminal nerve are rare and often present in the upper cervical skin. Patients with trigger points on the scalp often refuse to wash or comb their hair. Shaving is impossible for patients with trigger points on the upper lip or face. Patients with trigger points on the teeth or gums cannot perform oral hygiene. When swallowing or chewing stimulates pain, it may affect the patient’s eating and drinking. In severe cases, malnutrition or dehydration may occur. The distribution of trigeminal neuralgia pain The vast majority of patients with trigeminal neuralgia pain is limited to the skin area innervated by Sanya. A small amount of pain occurs simultaneously in the innervation region of the trigeminal nerve and the innervation region of the middle nerve (Ⅷ), glossopharyngeal nerve (Ⅸ), and vagus nerve (X). The most common areas of pain are the innervated areas of the second and third branches of the trigeminal nerve. The cheek is the most common site of trigeminal neuralgia. The pain syndrome can occur on both the face and any part of the forehead, and all combinations of pain sites have been reported. The course of trigeminal neuralgia is a disease with intermittent attacks. Many cases report intermittent periods of months or even years between the two attacks. The recurrences are almost in the same part of the face, but the range of pain tends to expand. Usually the interval between attacks gradually decreases and the severity and frequency of attacks gradually increase. Once some patients have the disease, there is no relief. Patients often complain of non-injurious small tingling in the painful area during severe pain episodes. Physiological and psychological stress significantly increased the pain of patients with trigeminal neuralgia, but there is no evidence that stress is the cause of the disease.

【Facial muscle spasm disease】 The location of facial nerve compression, which causes changes in the range of facial beating

Patients with facial muscle spasm always jump here and there, but it is actually quite annoying, so how does facial spasm occur? With so many nerves, blood vessels and muscles on the face, what is wrong? The muscle groups on the face are collectively called facial muscles, which are symmetrically distributed on the face. The movement of facial muscles is mainly dominated by the facial nerve. If the facial nerve is continuously stimulated, the facial muscles will twitch incessantly and involuntarily, which is called facial muscle spasm. Dr. Wang Jing, Department of Neurosurgery, Tangdu Hospital: Different parts of the facial nerve are compressed, resulting in different ranges of facial beating? The facial nerve starts from the brain, extends all the way to the face, and is divided into 5 branches here, respectively in charge of different parts. ①Temporal branch: branch muscle and orbicularis oculi muscle, this branch is generally less invaded by peripheral blood vessels; ②zygomatic branch: innervation of the orbicularis oculi muscle and zygomaticus muscle, when this branch is invaded by peripheral blood vessels, it is easy to jump the eyelids; ③Buccal branch: Dominates the buccal muscle, orbicularis oris muscle and other peripheral muscles of the mouth. When this branch is violated by the surrounding blood vessels, the cheek and mouth corner muscles will not work well; ④The mandibular branch: distributed in the muscles of the lower lip, such as lowering Lip muscles, masseter muscles, smile muscles, etc., when this branch is violated by the surrounding blood vessels, some expressions are difficult to make; ⑤ cervical branch: innervating the latissimus dorsi muscle, when the cervical nerve is compressed, the neck will twitch, facial muscles The cramps are more serious. We see here that we know which branch of the facial nerve is affected, and the muscles it controls may twitch; the more branches of the facial nerve involved, the greater the range of twitching, and the more serious the condition. Non-pathological eyelid jumps often have the following characteristics: ① the location of the beating is particularly uncertain, the left eyelid jumps for a while, and the right eyelid jumps for a while; ② the frequency of the beating is very irregular and may occur at any time; ③ the symptoms of eyelid beating are not The trend of aggravation has always been relatively slight eyelid jump; ④The range of beating is relatively certain, and it has been limited to the beating of the eyelid, and will not spread to the cheeks and mouth corners. In response to such eyelid jumps, reducing stress, avoiding irritation, and regular work and rest, most of the days will improve on their own. Some eyelid jumps are caused by inflammation of the eyes or other lesions, and the discomfort is always limited to the eyelids, and there is no tendency to expand to other parts of the face, such as myopia, hyperopia, conjunctivitis, keratitis, etc. It is time to see the symptomatic ophthalmology. If it is a long-term eyelid jump, and it gradually expands to the corners of the mouth or even the neck, the degree of facial beats gradually increases, which may be a precursor to certain facial nerve diseases, the most common of which is facial muscle spasm. 94% of facial muscle spasms start from eyelid beating. As the saying goes “the left eye jumps and the right eye jumps,” it is generally not easy to attract people’s attention. After a period of time, if the eyes cannot open, the corners of the mouth twitch, or even the neck twitch involuntarily, until the entire half of the face is not good, this is not a simple eyelid jump. Facial spasm is a disease in which the range of facial beats gradually expands and discomfort gradually increases.