Causes of Trigeminal Neuralgia:

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) Abnormal compression of the nerve by an adjacent blood vessel in the brain
2) Demyelination of the nerve (central and peripheral) that occurs as a result of nerve root injury
3) Physical damage to the nerve caused by dental or surgical procedures
4) Genetic tendency
5) Stress
6) Tumor and Multiple Sclerosis are some of the rare causes of TN

The role of stress in Trigeminal Neuralgia: 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.

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:

1. Stress
2. Exposure of cold wind
3. Brain trauma
4. Inadequate sleep
5. Poisoning with lead or other chemicals
6. Hormonal fluctuation before and after the menses
7. Hyperglycemia (High blood sugar)
8. 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.