Conditions

Let’s figure out what’s causing your symptoms.

Dealing with facial pain can take you away from the every day activities you love to do. You owe it to yourself to understand the condition that is consuming your life and our neurosurgeons are here to help you throughout the process. To better diagnose your pain and symptoms, here is a list of conditions that our neurosurgeons treat in NJ.

Classic
Trigeminal Neuralgia

Trigeminal Neuralgia
Type 2

Hemifacial
Spasm

Nervus
Intermedius
Neuralgia

Anesthesia
Dolorosa

Classic Trigeminal Neuralgia, Type 1

What is Trigeminal Neuralgia?

Trigeminal Neuralgia – also called tic douloureux – is a facial pain condition that affects the largest nerve in the head, the fifth cranial (trigeminal) nerve. The trigeminal nerve carries sensations from the face to the brain.

TN is often caused by loss of or damage to the nerve’s protective coating, myelin. The damage of the myelin results from irritation of the nerve, most often triggered by compression of the trigeminal nerve by a normal blood vessel next to the brainstem.

The pain attacks worsen over time. As the condition progresses, there are fewer and shorter pain-free periods before they recur. This facial pain condition affects the quality of one’s life, making everyday activities harder for the individual.

Symptoms of Trigeminal Neuralgia

Trigeminal Neuralgia patients have experienced some or all of the following symptoms:

  • Pain episodes affect one side of the face.
  • Sporadic burning or shock-like facial pain.
  • Pain felt near the lips, eyes, nose, scalp, forehead, upper and lower jaw.
  • Pain triggered by touch, sounds or everyday activities.
  • Pain episodes last from a few seconds to a couple minutes.
  • Tingling, numb sensation or constant aching pain before a new episode begins.

Trigeminal Neuralgia, Type 2

What is Trigeminal Neuralgia Type 2?

The atypical form of the disorder known as Trigeminal Neuralgia Type 2 (TN-2), is characterized by a constant aching, burning and stabbing pain of somewhat lower intensity when compared to Type 1.

TN-2 is categorized to be more than 50% constant pain as opposed to sharp and fleeting pain. Both forms of pain may occur in the same person, sometimes at the same time.

TN-2 cases are presumed to be caused by a compression, except the compressions are occurring to the nerve’s motor branch and affect delayed-pain-carrying nerve fibers instead of “fast” pain fibers, or have created long-term, chronic injury anywhere along the nerve’s course.

Symptoms of TN-2

Trigeminal Neuralgia Type 2 patients have experienced some or all of the following symptoms:

  • Constant aching, burning, stabbing pain.
  • Painfelt near the lips, eyes, nose, scalp, forehead, upper and lower jaw.
  • Pain triggered by touch, sounds or everyday activities.
  • Used to have primarily stabbing, fleeting pain but now have more burning, constant pain.

Hemifacial Spasm

What is Hemifacial Spasm?

Hemifacial Spasm, which is also known as a facial twitch, is a frequent involuntary twitch on one side of the face. In most cases, the twitching starts around the eye area and progresses to other parts of the face. The neck and forehead are usually the last parts of the face to be affected by hemifacial spasm.

As time progresses, the patient will have prolonged muscle contractions in the affected areas of the face. These extended contractions result in severe disfiguring and grimace in the face as well as eye closure and the corner of the mouth being pulled upwards on one side.

Hemifacial spasm is caused by a blood vessel pressing on the facial nerve where the nerve exits the brainstem. This is a debilitating disease that can greatly affect one’s quality of life.

Symptoms of Hemifacial Spasm

Hemifacial Spasm patients have experienced some or all of the following symptoms:

  • Irregular twitching in the eyelid muscle.
  • Twitching can lead to a forced closure of the eye.
  • Spasm can spread to other muscles in the lower part of the face.
  • Spasm can cause the mouth to pull to one side.
  • Although rare, spasm can be on both sides of the face.

Nervus Intermedius Neuralgia

What is Nervus Intermedius Neuralgia?

Nervus Intermedius Neuralgia (also referred to as “geniculate neuralgia”) results when the nervus intermedius nerve deep in the ear is compressed by a blood vessel. When the Nervus Intermedius nerve is compressed symptoms include cluster headaches and deep ear pain.

Similar to Trigeminal Neuralgia, this facial pain condition is characterized by sharp, stabbing, electric like sensations. The pain strikes deep in the ear and attacks may last for minutes or drag on for hours.

Some patients describe Nervus Intermedius Neuralgia pain as feeling like they have an ice pick in their ear. Common pain triggers include, light touch of the ear, chewing, swallowing and talking.

Symptoms of Nervus Intermedius Neuralgia

Nervus Intermedius Neuralgia patients have experienced some or all of the following symptoms:

  • An intermittent stabbing pain deep in the ear.
  • Ringing or buzzing in the ears (tinnitus).
  • Bitter taste in the mouth.
  • Cluster headaches.
  • Excess salivation.
  • Dizziness or vertigo.

Anesthesia Dolorosa

What is Anesthesia Dolorosa?

Anesthesia Dolorosa (AD) is one of the most dreaded complications of the treatment of trigeminal neuralgia. It occurs when the trigeminal nerve is damaged by surgery or physical trauma, resulting in numbness in the face, with pain present within the numb area.

AD is caused by injury to the trigeminal nerve, either deliberately as during ablative treatment for trigeminal neuralgia, or accidentally as during injury to the trigeminal nerve for some other reason.

The diagnosis of AD is made when patients have an area of total numbness in the face that is also painful. Quantitative sensory testing is a test that confirms that the affected area is, in fact, numb, but this test is not necessary to make the diagnosis. If the painful area of the face has partial sensation, then the correct diagnosis is trigeminal deafferentation pain (for patients whose injury occurs during treatment for trigeminal neuralgia) or trigeminal neuropathic pain (for patients without trigeminal neuralgia).

Symptoms of Anesthesia Dolorosa

Anesthesia Dolorosa patients have experienced some or all of the following symptoms:

  • Facial numbness (much like the numbness from a dental anesthetic injection).
  • Constant pain in the form of burning, pulling or stabbing but can also include a sharp, stinging, shooting or electrical component.
  • Pressure and “heaviness” can also be part of the pain symptoms.
  • Eye pain.
  • Feeling of numbness associated with cold temperatures. (sometimes making the face feel “frozen”)

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