The
Trigeminal Nerve
The trigeminal nerve
is one set of the cranial nerves in the head. It is the nerve responsible for
providing sensation to the face. One trigeminal nerve runs to the right side of
the head, while the other runs to the left. Each of these nerves has three distinct branches. "Trigeminal" derives from the
Latin word "tria," which means three, and "geminus," which
means twin. After the trigeminal nerve leaves the brain and travels inside the
skull, it divides into three smaller branches, controlling sensations
throughout the face:
·
Ophthalmic
Nerve (V1):
The first branch controls sensation in a person's eye, upper eyelid and forehead.
·
Maxillary
Nerve (V2):
The second branch controls sensation in the lower eyelid, cheek, nostril, upper
lip and upper gum.
·
Mandibular
Nerve (V3):
The third branch controls sensations in the jaw, lower lip, lower gum and some
of the muscles used for chewing.
Trigeminal neuralgia
symptoms may include one or more of these patterns:
·
Episodes of severe, shooting or jabbing pain that may feel like
an electric shock
·
Spontaneous attacks of pain or attacks triggered by things such
as touching the face, chewing, speaking or brushing teeth
·
Attacks of pain lasting from a few seconds to several minutes
·
Pain that occurs with facial spasms
·
Bouts of multiple attacks lasting days, weeks, months or longer
— some people have periods when they experience no pain
·
Pain in areas supplied by the trigeminal nerve, including the
cheek, jaw, teeth, gums, lips, or less often the eye and forehead
·
Pain affecting one side of the face at a time
·
Pain focused in one spot or spread in a wider pattern
·
Pain rarely occurring at night while sleeping
·
Attacks that become more frequent and intense over time
Causes –
There are two types of
TN — primary and secondary. The exact cause of TN is still unknown, but the
pain associated with it represents an irritation of the nerve. Primary
trigeminal neuralgia has been linked to the compression of the nerve, typically
in the base of the head where the brain meets the spinal cord. This is usually
due to contact between a healthy artery or vein and the trigeminal nerve at the base of the
brain. This places pressure on the nerve as it enters the brain and causes the
nerve to misfire. Secondary TN is caused by pressure on the nerve from a tumor, cyst, facial injury or another
medical condition that damages the myelin sheaths.
Attacks of TN may be
triggered by the following:
·
Touching the skin lightly
·
Washing
·
Shaving
·
Brushing teeth
·
Blowing the nose
·
Drinking hot or cold beverages
·
Encountering a light breeze
·
Applying makeup
·
Smiling
·
Talking
·
Diagnosis
·
TN can be very difficult to
diagnose, because there are no specific diagnostic tests and symptoms are very
similar to other facial pain disorders.
CASE –
One of my patients relative of age 68, was suffering from facial
pains since last 15 years which became worse nowadays ,after years of various
treatments they now decided to take homoeopathic medicines and they came for
homoeopathic treatment on 10/05/2023.
All sufferings were since 15 years so patient was more habitual
of suffering now.I remember Dr Hahnemann’s apho.no.99 where he specifies how acute cases have fresh
memory of symptoms and which is one of obstacle of chronic case taking during taking chronic case many of the
symptoms patient forget to narrate because he is habitual of it.
K/C/O – Trigeminal Neuralgia
C/C – pain in facial region since 30 years.
Skin eruption since 4 years.
H/O/C/C – 1)pain in facial region since 15 years
location –left side of face from ear to ophthalmic region also
around buccal region
sensation –tingling followed by numbness
modality – Agg. Early morning ,Cold air exposure, Biting hard
subject ,Touch
Ame. Rubbing smoothly , Rest
2) Skin Eruptions since 4 years
Location – bilateral buttock region
Sensation –burning all over eruptions
Modality –Agg – night
Ame – itching ,cold application
P/H – no any
F/H –no any
Physical General –
Habbit – tobacco(misri)3 times /day
diet –mixed
desire –sweets
aversion – no any
chest –pains ocassionally on left side
>rest
neck and back –no any complaint
LE and UE – No complaint
Bowel – regular sometimes constipation
Bladder –urgency of urination
Sleep – disturbed due to skin complaint
Dreams –
Perspiration –profuse
Thermal – chilly
Ob/h – 1 son 1 daughter normal delivery
Mind –Patient is housewife.Patient is calm and sensitive
emotionally.She is very religious person.Her husband is dominating by nature.15
year back her daughter did intercaste marriage that was shocked her since then
she started specifically facial pains .Previously there was issue with daughter
but now everything she accepted and her relation with her daughter is good.She
has frightful nature .she always thinks and worries about her children .she loves
to do all household work previously but now since her daughter in law came she
wants to retire herself .
Totality of symptoms –
Remedy selection –
Spigelia is a neuralgic remedy.Spigelia is left sided drug
coming from Loganiaceae family.It is a drug for tobacco habituals.Also this
drug very well suits to people having complaints of chest pains and who are
emotionally sensitive and frightened personalities .Nature of pain of Spigelia
is same as described by patient which is sudden ,twitching and tearing of left
side of face ,ear and lower jaw and aggravated by mastication.So Spigelia
selected as a drug to be given in this case.
Treatment –
10/05/2023 Spigelia 30 3 doses was selected to give her for 3
days and then followed by SL for 15 days.
25/05/23 –Followup –patient came with complaint of lacrimation
during daytime other pains intensity was tolerable without taking allopathic
pain killers .G.C.better.
BP-140/90 . Spigelia 30 was repeated again for 4 days 3 doses
and followed by 1 month SL.
24/06/23 –Followup – Patient had 50 % better complaints of
facial pains which was triggering at sudden .onset was slow .lacrimation
stopped .skin eruptions complaint was also improved .Spigelia 30 stat dose
given at OPD and followed by 2 months SL.
25/08/23 –Patients complaints were reduced which was shooting
unexpectedly ,now she is suffering from complaints only while eating when hard
objects and duration of pains also reduced.
Spigelia 30 dose given followed by 2 months SL.
27/10/23 - Patient had no any more complaint about facial pains
she has started going to visit her relatives which she stopped previously
because of unnatural course of facial pains.She was very happy with her
recovery and also she was thankful to the relative who suggested her to take
homoeopathic treatment.
Conclusion – Trigeminal Neuralgia is a
neurological disorder .Pains are intolerable which can be reversed with
homoeopathy .It is possible when you have knowledge of disease ,knowledge of
organon and knowledge of repertory and material medica .Totality of symptoms is
always a key to reach the similimum.When you reach at similimum then only you
get result in every aspect of person.
