• Though brought into focus by superstar Salman Khan, who has been undergoing treatment for the disease in US, physicians still need to be more aware towards the disease for its early diagnosis

NewZNew (S A S Nagar) : It is among the most painful conditions known to humankind. Trigeminal Neuralgia (TN), a chronic pain condition associated with nerve injury or nerve lesion that causes extremely severe, sporadic, sudden burning or shock-like facial pain, has recently been in the news because of superstar Salman Khan getting treated for the disease in the USA.

It is estimated that 1 in 15,000 or 20,000 people have TN, though the figure may be much higher since the disease is most often misdiagnosed. A TN sufferer will sometimes seek the help of numerous clinicians before a firm diagnosis is made. Many patients get all their teeth extracted on the affected side of the face in the hope of some relief in the absence of proper diagnosis.

Presenting two recent cases of patients suffering from this disease before the media, Dr Avtar Singh Matharoo, Consultant, Interventional Pain Management, at Fortis Hospital Mohali, said it is very important that patients of TN are diagnosed early because it can have a significant impact on a person’s quality of life, resulting in problems such as weight loss, isolation and depression.

Mrs Lalita Sharma (74, Chandigarh), who was hypertensive, suffered from Trigeminal Neuralgia since 2008. She had severe pain in the right cheek and found it unbearable to eat, talk, or even smile. It would get triggered by simple daily activities such as brushing the teeth or air touching her cheek etc. Her life was miserable. After consulting various doctors, including her own daughter and
son-in-law, and not finding relief from the pain, she decided to consult Dr Matharoo, who treated her with Radiofrequency Ablation late last year. On her subsequent follow ups, Mrs Sharma has revealed that she is now completely pain free and is comfortable and thankfully back to normal life.

The other case was Surjan Singh from Dasuya in Punjab. In his early 50s Surjan   had been tolerating shooting pain in the left cheek for the last 10 years. As he shuttled from one doctor to another with the disease remaining undiagnosed, he even got all the teeth removed from his left jaw but still did not receive any relief. He finally presented himself before Dr Matharoo following which he was correctly diagnosed and received immediate relief.

Dr Matharoo said there are three forms of treatment available for TN – medicines (which one has to take for life), surgery (open & percutaneous) and Gamma Knife Radiation (which is extremely expensive and the results last just a few months).

Drug used in TN treatment are similar to the ones used in treating epilepsy and cause extreme sedation and laziness. Besides they may cause various other serious side effects like bone marrow suppression.

Open surgery is indicated in cases where a definite compression over the origin of the nerve due to vascular loop or tumour is present. It is a major intervention where the skull is opened from behind through a 4-6 inch incision. Though it has its own favourites but is certainly fraught with major risks including deafness.

Percutaneous surgery, known as “Radiofrequency Ablation (RFA)” is a stitch-less procedure, under local anesthesia, usually done as a daycare procedure. RFA controls pain immediately by precisely lesioning the specific branch of the nerve without any alteration in the other divisions. It is an extremely safe procedure that can be done even in the elderly and frail patients.

Dr Matharoo said, “With a success rate of 97%, RFA is the least invasive treatment with tremendous benefits. Its positive effects persist for an average of 2-3 years though many of my patients are enjoying a pain free life for more than 20 years”. Dr Matharoo sympathized deeply with the TN patients and felt that such patients are most often left to suffer relentlessly for no fault of their.

He said: “In most cases, TN symptoms begin appearing more frequently over the age of 50, although there have been cases with people being as young as three years of age suffering from the disease. It is more common in females than males.”