Trigeminal Neuralgia Causes

The exact cause of trigeminal neuralgia is not clearly understood but there are certain factors that can trigger the onset of trigeminal neuralgia. These are as follows:

1) Compression: Abnormal compression of the nerve by an adjacent blood vessel in the brain

2) Demyelination: Demyelination of the nerve that occurs as a result of nerve root injury
 

3) Nerve damage: Physical damage to the nerve caused by dental or surgical procedures
 

4) Genetic tendency:  When we say genetic, it does not mean that every patient of TN has someone in the family having TN. Actually, there supposed to be a group of genes which are inherited and they evolve in certain way, when supported by other factors, leading to have TN. Only little understanding is achieved in this area, yet.
 

5) Stress:  Psychological stress is one of the triggering and aggravating factors if not primarily causative factor. It is a well-known fact that there is an inseparable bond between mind and body and that the psyche plays a vital role in maintaining health or causing diseases. It is a common experience in clinical practice that some patients report the onset of trigeminal neuralgia following major stressful events like divorce, death of close relatives, change of job, unhealthy family relationships, etc and this perception of patients that psychological stress can worsen trigeminal neuralgia has been supported in clinical studies.

Stress has been identified as an important cause in triggering as well as maintaining trigeminal neuralgia especially in the chronic cases. Stress can be in the form of:

• Prolonged anxiety due to any cause
• Grief, depression
• Suppressed anger/emotions
• Guilt
• Frustrations
• Despair
• Disappointments in life
• Nervous temperament
• Failures in business, etc.

Frustration due to the unexplainable nature of the disease only makes the matters worse for the patient. Not all cases have a clear-cut cause and in many cases the cause may remain obscure i.e. idiopathic.

6) Tumor and Multiple Sclerosis are some of the rare causes of TN

7) Immunological factors: Certain immunological parameters are found to be affecting TN in different ways. Immunity is now considered to be an important factor for pain and TN. Also, immunity is controlled and affected by emotional (stress) factors as well as genetic factors.

Multiple causes: It has been observed that TN often is backed by more than one causes. As one can see, immunological causes are supported by stress and genetic factors; suggesting the causative factors work in a chain and they are interconnected.
 

Factors governing Pain and seizure threshold:
Episodes of trigeminal neuralgia increase when the patients pain threshold gets lowered. The pain threshold is affected by several known and unknown factors, some of them are:

• Stress
• Exposure of cold wind
• Brain trauma
• Inadequate sleep
• Poisoning with lead or other chemicals
• Hormonal fluctuation before and after the menses
• Hyperglycemia (High blood sugar)
• Certain antibiotics and anesthetic agents

Ectopic action potential generation in the sensory root of the nerve may be responsible for the typical, episodic, electric, lancinating pain of TN.

Click to see animation on Trigeminal Neuralgia