By Hoba Pain and Motion Blog November 2, 2020

Where is the Trigeminal Nerve?

There are 12 cranial nerves that originate from the brain and go down to different parts and organs to transmit sensory and motor signals. They come in pairs and the Trigeminal nerve is almost the largest one. The trigeminal nerve is the 5th paired cranial nerve that innervates the skin, mucous membrane, and sinuses of the face. It supplies the sensory information of the face and controls motor information of jaw muscles and mastification. It has 3 major branches.

Ophthalmic
Maxillary
Mandibular

Trigemnial nerve anatomy - Trigemnial nerve branches and pain areas — Trigemnial nerve anatomy – Trigemnial nerve branches and pain areas

What does Trigeminal nerve do?

Trigeminal nerve has 3 branches with 3 different duties:

1.Ophtalmic Branch

The Ophthalmic branch of the trigeminal nerve is responsible for sensory information of the Scalp, forehead, upper parts of the sinuses, upper eyelid and their mucous membranes, the cornea of the eye, and the bridge of the nose.

2. Maxillary branch

The Maxillary branch of the Trigeminal nerve is responsible for sensory information of the Lower eyelid, middle sinuses, nasal cavity,cheeks, upper lip, roof of the mouth and upper teeth and the associated mucous membranes.

3.Mandibular branch

The Mandibular branch of the Trigeminal nerve is responsible for the sensory information of the outer part of the ear, the lower part of the mouth, the front and middle parts of the tongue, lower teeth, lower lip, chin. The mandibular branch also controls the movements of jaw muscles and inner ear.

Trigeminal Neuralgia

Trigeminal neuralgia is a chronic neuropathic pain syndrome that affects the trigeminal nerve, which as I mentioned above carries sensation from your face to your brain and controls movement of the inner ear and jaw muscles. when you have trigeminal neuralgia, even mild stimulation of your face — from cold weather to brushing your teeth, chewing, talking, blowing the nose and even putting on makeup — may trigger excruciating pain on your face. At first, it starts with short attacks but later it becomes more severe and will bring searing pain. It is more common in women especially those who are older than 50.

The “classic” form of the Trigeminal Neuralgia(“Type 1” or TN1) causes extreme, sporadic, sudden burning sensation or shock-like facial pain that lasts anywhere from a few seconds to as long as two minutes per attack. These attacks can occur in quick succession, in volleys lasting as long as two hours. The “atypical” form of the Trigeminal neuralgia(“Type 2” or TN2), is characterized by constant aching, burning, stabbing pain of somewhat lower intensity than Type 1.

What Causes Trigeminal Neuralgia?

Trigeminal Neuralgia can be caused by a blood vessel pressing on the trigeminal nerve as it exits the brain stem. This compression causes damage to the protective coating around the nerve (the myelin sheath). Trigeminal neuralgia symptoms can also occur in people with multiple sclerosis, a disease that causes deterioration of the trigeminal nerve’s myelin sheath. Rarely, symptoms of Trigeminal neuralgia may be caused by nerve compression from a tumor, or a tangle of arteries and veins called an arteriovenous malformation. Injury to the trigeminal nerve (perhaps the result of sinus surgery, oral surgery, stroke, or facial trauma) may also produce neuropathic facial pain.

What should YOU DO?

First step is seeing your family doctor and checking your conditions with them.

Osteopathy for Trigeminal Neuralgia, or Trigemnial nerve pain

Osteopathy is a gentle holistic approach that focuses on the alignment of different parts of the body, and a manual osteopath can help patients with the Trigeminal Neuralgia by re-aligning the jaw muscles and other facial structures, and by loosening up tissues compressing the trigeminal nerve. Sutherland was one of the founders of cranial osteopathy and his observation of the disturbed physiology of the dural membrane enveloping the Gasserian ganglion as a result of articular strain between the petrous portion of the temporal bone and the sphenoid bone has been supported by the observation of a structural imbalance between the right and left temporal bones where the Trigeminal nerve passes over the petrous apex. Release of dural stresses due to strains on the cranial articulations and elsewhere in the body is helpful, particularly after early diagnosis by your family doctor. The results would be fewer attacks and the severity of the attacks can also be reduced. Osteopathy can also trigger a parasympathetic response which relieves the tensions in the patient’s nervous system.