By: Dr John Conde DC, DACNB Special to the Boca and Delray newspapers
Trigeminal neuralgia, also known as tic douloureux, is a disabling condition that affects the fifth cranial nerve (trigeminal nerve) located within the skull. It usually occurs most often in people over 50, although it can occur at any age, including infancy. The disorder is more common in women than men and is noted in 12 per 100,000 people per year.
The trigeminal nerve is one of 12 pairs of nerves that are attached to the brain within the skull and is the most widely distributed nerve in the face. It is irritation and disturbance of this nerve anywhere from the brain stem in an area called the pons to the face that is the genesis of this condition. The disturbance of the trigeminal nerve can be secondary to physical compression or physiological dysfunction. In the case of physical compression of the nerve, it is noted that blood vessels as well as tumors in the base of the brain can damage the nerve. We sometimes see facial blunt trauma also be a causative agent. Physiological dysfunction is often noted due to erratic and unstable behavior of the cluster of neurons in the brainstem that forms the nerve and can be spontaneous and idiopathic (unknown cause) or from conditions that slow down nerve conduction like multiple sclerosis and stroke. There are two types of trigeminal neuralgia, typical (TN1) and atypical (TN2).
The most common traditional treatments for trigeminal neuralgia include microvascular decompression surgery, cyber knife radiosurgery, and anticonvulsants such as carbamazepine. Unfortunately the outcomes offered by these therapeutic interventions are not great and they provide great risks in regards to surgery and significant side effects in reference to the medication. It would be prudent of the clinician to recommend novel, non-invasive and non-pharmaceutical therapies first which are gaining momentum in the treatment of trigeminal neuralgia. The most exciting and promising of these treatment options include photobiomodulation (class IV laser therapy), transcutaneous electrical nerve stimulation (TENS), functional neurological intervention, chiropractic manipulative therapy, dietary changes, and supplementation.
The goal of these treatments is to stabilize the activity level of the trigeminal nerve and the neuronal pools located in the brainstem so there is less spontaneity. In regards to class IV laser therapyit draws water, oxygen, and nutrients to the tissue to accelerate healing mechanics. The light interacts with tissues at the cell level to increase energy and protein production thereby stabilizing the activity of the cell. Functional neurological intervention includes using targeted environmental sensory stimuli like pneumatic insufflation (blowing air in the ear canal), eye movements, head movements, and or balance activities to make changes in the neurological pathways involved in the genesis of this condition.
Dr. John Conde is a Board Certified Chiropractic Neurologist, one of only one thousand in the country. He holds diplomate status through the American Chiropractic Neurology Board. He provides specialized care for difficult cases of back neck pain, numbness-tingling, vertigo-dizziness balance disorders, fibromyalgia, migraines, AD/HD, autism, and dyslexia. His office is located at the Atlantic Grove in Delray Beach, FL and can be reached at 561-330-6096, firstname.lastname@example.org, and at www.thecondecenter.com