Actor Salman Khan has been quite vocal about his battle with Trigeminal neuralgia, a nerve disorder, often describing it the ‘most painful’ condition he has lived with.On Two Much with Kajol and Twinkle, Salman recalled going through the pain for years. He shared, “When I had trigeminal neuralgia, that pain used to be… You would not want your biggest enemy to have that pain. And I had it for seven and a half years.”He also added, “And this used to happen every four-five minutes. It used to take me an hour and a half to have my breakfast and I used to go straight to dinner. For an omelette, it used to take me… because I couldn’t… so I used to force myself (to eat),” he said, and recalled that even painkillers wouldn’t help.
Salman said the pain is gone but recalled, “It is the worst pain. It is called ‘the suicidal disease.’ The highest number of suicides happen because of this condition. Salman explained that he shared his experience to raise awareness, as many people suffer from the condition but few know about it.He further stated, “Now it is very easily treatable. There is a gamma knife surgery. They fix screws on your face for 7-8 hours. They make you lie down and with the gamma knife…” he said as he recalled going through eight of surgery. He shared that after the surgery, he was told that his pain might reduce by 20-30 percent but luckily, it went away completely.
“Now the aneurysm is there. An arteriovenous malformation is present. But you have got to live with it. There are a lot of people living with bypass surgeries, heart conditions and so many other things, he added.What trigeminal neuralgia really isTrigeminal neuralgia is a chronic nerve disorder causing sudden, stabbing, electric-shock-like pain in areas like the cheek, jaw, teeth or forehead served by the trigeminal nerve. The attacks duration ranges from several seconds to two minutes, while they deliver multiple strikes which activate when someone touches the area, or when they chew, or brush. The period between episodes brings no pain, but people stay away from regular activities, because they worry about triggering their condition. It rarely affects both sides, and mostly hits one, or more branches of the nerve.Main causes behind the nerve painThe blood vessel which usually takes the form of the superior cerebellar artery, creates pressure on the trigeminal nerve root at its brainstem location, to damage its myelin sheath protective covering. The compression system produces defective pain signals, which transform regular skin contact into painful electrical shocks. Less common triggers include Multiple sclerosis plaques that damage nerve tissue through demyelination and tumors, which include meningiomas, cysts and nerve injuries, that result from surgical procedures or traumatic events and strokes. The scans fail to reveal any identifiable reason for the rare spontaneous occurrence of this condition.
Who is at riskWomen develop this condition at rates 1.5 to 3 times higher than men, and research shows it affects 0.16% to 0.3% of the population throughout their lives. The risk of developing this condition increases with age starting at 50, until it reaches its highest point of 23 cases per 100,000 people, who are 80 years old or older. The condition affects people of all ages, because it can occur in both elderly patients, children and young adults. The combination of multiple sclerosis with nerve damage creates a 400 times higher risk, while high blood pressure might play a role in this condition. The condition is not usually genetic.Recognising the shock-like attacksThe pain sensation resembles lightning attacks, that affect one facial side where it typically appears in the jaw or cheek area, without any signs of swelling or redness. The triggers for the condition include smiling, washing face, eating cold foods, and feeling the breeze which normally trigger ordinary activities that lead to multiple attacks. The warning system of some people produces a short tingling sensation, before their body experiences an explosive reaction, while others experience ongoing pain between their shock episodes. The condition differs from toothaches and sinus problems, because it avoids the face center and does not react to standard pain medications.TreatmentThe combination of carbamazepine or oxcarbazepine which regulates nerve activity, helps patients achieve initial pain control in 70-80% of cases, through once-daily medication for seizure prevention. The treatment of dizziness side effects includes using baclofen, gabapentin and lamotrigine as add-ons, or Botox injections for patients. The treatment of pain flares requires short-term opioid use, but patients who take opioids for extended periods will develop drug dependence.Surgery options when pills failThe treatment for vessel compression involves microvascular decompression, which removes the artery from its position on the nerve, to achieve an 80% success rate in long-term relief but it creates a risk for patients to experience either hearing problems or stroke. Gamma knife radiosurgery performs non-invasive root treatment which brings pain relief to 70% of patients, through months of treatment without requiring surgical incisions. The combination of glycerol injections with radiofrequency ablation procedures, produces short-term nerve numbness but patients need to undergo multiple procedures and some patients will experience lasting numbness, as a treatment complication.Disclaimer: This article is informational only and not a substitute for medical advice
