Understanding The Link Between MS And Trigeminal Neuralgia

Understanding The Link Between MS And Trigeminal Neuralgia

May 30 is World Multiple Sclerosis Day, which is a day to raise awareness and bring the global multiple sclerosis (MS) community together. MS is a condition that affects the brain and spinal cord, and can lead to a wide range of symptoms. One of the lesser-known symptoms of MS that can affect quality of life is trigeminal neuralgia (TN).

Here’s a more detailed look at these conditions, including the options for trigeminal neuralgia treatment.

What Is Multiple Sclerosis (MS)?

MS is an autoimmune condition that causes the body’s immune system to mistakenly attack the myelin sheath, which is the protective covering around the nerves in the central nervous system. This disrupts the flow of information within the brain and between the brain and the body, resulting in a range of symptoms.

What are the symptoms of MS?

MS can affect different parts of the central nervous system, so everyone’s experience of it will be different. The symptoms can wax and wane (Relapsing-remitting MS or RRMS) or get progressively worse over time. Some people move into this phase after the RRMS stage, or it begins as soon as the symptoms first begin to appear.

The most common symptoms include:

• Fatigue – one of the most disabling symptoms, often not visible to others
• Vision problems – blurred or double vision, or even temporary loss of vision
• Muscle weakness and spasms – especially in the legs or arms
• Balance and coordination issues – leading to unsteadiness or falls
• Numbness or tingling – often starting in the face, arms, or legs
• Bladder and bowel problems – urgency or difficulty emptying the bladder
• Cognitive changes – such as memory issues or slowed thinking
• Pain – including nerve pain, which is where trigeminal neuralgia can come in

What is trigeminal neuralgia?

Trigeminal neuralgia (TN) is a chronic pain condition that affects the trigeminal nerve, which carries sensation from the face to the brain. It is often described as a stabbing or burning sensation in one side of the face, and can occur in brief bursts that may repeat several times during an attack. Some people with TN experience continual pain.

According to the MS Society, TN affects about two to five per cent of people with MS at some point, and it can also affect people who do not have MS. The level of pain experienced with TN can be excruciating, and even when it recedes, patients experience a dull burning sensation in the affected area.

TN attacks can be unpredictable and intense, which makes it a very difficult and distressing condition to live with. The pain can be triggered by regular activities such as eating, talking or any physical contact with the face. It can sometimes be mistaken for dental pain, so instances of TN may be underdiagnosed in the general population.

What causes TN?

In cases where TN is related to MS, it is caused by nerve damage around the trigeminal nerve root. There is a trigeminal nerve path on each side of the face, with three main branches. The exact location of the face pain will depend on which trigeminal branch or branches are affected.

In cases where TN occurs in people without MS, it’s most often caused by a blood vessel pressing on the nerve inside the skull.

What are the treatment options for TN?

The first line of treatment for TN is usually prescription painkillers (regular painkillers such as paracetamol and ibuprofen are ineffective for treating nerve pain). If drug treatment is ineffective, then surgical options might be considered. In this case, the patient will be referred to a neurosurgeon who will determine the best treatment pathway.

Stereotactic radiosurgery

One treatment option that might be considered is stereotactic radiosurgery (SRS). One of the most highly regarded forms of SRS is Gamma Knife surgery. This is a non-invasive procedure that uses highly focused beams of radiation to target the trigeminal nerve root, disrupting the pain signals.

Gamma Knife has a high success rate and a lower risk of side effects than many other forms of surgery, making it the preferred option for leading neurosurgeons. It is usually delivered in a single session, and involves minimal recovery time.

If you or a loved one is experiencing facial pain with MS or has a diagnosis of TN and you are interested in finding out more about Gamma Knife treatment, please talk to our team today.

Centres of Excellence for Stereotactic Radiosurgery treatment of complex Brain Tumours