Álvaro Morata, center forward of Atlético de Madrid, was unable to train this Tuesday with the rest of the team because he suffers from an acute case of trigeminal neuralgia. It is a very disabling pathology because it produces what is considered ‘the worst pain in the world‘ in the maxillary, mandibular and/or ophthalmological area. It generally affects only one side of the face, although it can occur on both.
The trigeminal neuralgia It is a disorder that affects one or more branches of the nerve responsible for transmitting sensitivity from the face to the brain, called trigeminal nerve. It differs from other types of facial or headache pain because the discomfort is very intense and has a sharp or electric.
The Spanish Society of Neurology (SEN) estimates that trigeminal neuralgia affects more than 35,000 people in Spain. «Although its prevalence is not very high, since it is estimated that only 0.3% of the population will develop this disorder throughout their life, it represents a significant problem due to its underdiagnosis and undertreatment, but also due to the high impact on the quality of life of people who suffer from it,” explains Dr. Pablo Irimia, coordinator of the Headache Study Group of the Spanish Society of Neurology. «Pain can occur spontaneously, but it is also very common for it to be activated by tactile or thermal stimuli (such as chewing, speaking, combing one’s hair, brushing one’s teeth, eating or yawning). That is Daily activities can trigger a very disabling pain crisis«warns the expert.
exist three types of trigeminal neuralgia: classic, secondary and idiopathic. The classic one is the most common and is caused by compression of the root of the trigeminal nerve. Secondary, which represents approximately 15% of cases, occurs due to some other identifiable disease, where brain tumors, fractures or facial surgeries, infections (such as shingles) or degenerative diseases (such as multiple sclerosis) are usually behind most cases. When no apparent cause can be found, it is called idiopathic and this type represents approximately 10% of cases. Familial cases are rare, but may be present in 1-2% of patients.
«In any case, regardless of the type of trigeminal neuralgia suffered, the symptoms and characteristics of the disease are similar. Practically the only difference is that patients with secondary trigeminal neuralgia tend to be younger, more likely to have sensory loss in one part of the face and are more likely to have bilateral facial pain,” explains Dr. Pablo Irimia.
Every year, around 2,000 new cases of trigeminal neuralgia are diagnosed in Spain, although its annual incidence is much higher, according to data from the SEN. It is estimated that the diagnosis of this disease is delayed at least a year after the appearance of symptoms since, in almost half of the cases, This ailment can be confused with other more common ailments. such as migraine, cluster headache, tension headache, dental or temporomandibular joint problems, glaucoma, otitis and tonsillitis.
«Correctly identifying patients is important because there are numerous therapeutic options. And although it is a difficult disease to manage, with medical treatment, approximately 80-85% of patients remain pain-free in the long term,” says the expert.
There are several pharmacological alternatives with which a response is achieved in more than 60% of patients. Botulinum toxin infiltration may be another therapeutic option for patients who do not show improvement with initial treatment. For those who do not feel improvement with the drugs, with intolerance to the treatment or for whom the medications have stopped being effective over time, there are different radiofrequency procedures and surgical techniques that relieve and even make the pain disappear at a high level. percentage of patients.
