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Journalism of Courage
Salman Khan has been known to battle trigeminal neuralgia, where a nerve that carries signals from the face to the brain malfunctions and is compressed, causing intense and stabbing pain on the face. During a recent talk show hosted by his one-time co-actors Kajol and Twinkle Khanna, he has once again opened up about the severity of pain that he endured.
Often called the suicidal disease, because the piercing pain literally drives one to feelings of hopelessness and desperation, Khan revealed how his symptoms first appeared on the set of the 2007 film Partner, when actor Lara Dutta moved a strand of hair from his face. On living with the condition for seven-and-a-half years, Khan said, “It used to pain every 4-5 minutes. It would happen suddenly. It used to take me about an-hour-and-a-half to have my breakfast. For an omelette, I couldn’t chew it, I had to force myself, hurt myself, take as much pain, so I could get rid of the meal.” He even had a surgery in 2011 to relieve pressure on this nerve.
“Even a light touch from brushing your teeth or putting on makeup may trigger pain equivalent to an electric shock,” says Dr Praveen Gupta, Chairman, Marengo Asia International Institute of Neuro & Spine (MAIINS), Marengo Asia Hospitals, Gurugram.
Trigeminal neuralgia is a condition of the trigeminal nerve, which carries signals from the face to the brain. This nerve has three parts. The first part covers the eye and the forehead. The second part covers the upper part of the upper jaw and the lower part covers the lower part of the lower jaw. So when any part malfunctions, the patient experiences a piercing pain akin to an electric shock that courses through their face to the head. This can be worsened by talking, eating food or touching the face.
Whenever the patient has the slightest facial movement, an electric impulse goes back to the trigeminal nerve nucleus, which fires back as an intense but short pain. Since patients experience pain in the face region, a lot of them go to dentists believing it to be a tooth problem. It’s more common in women and people older than 50 and can be managed with treatment.
Common causes are an artery or vein accidentally pressing on the nerve. Sometimes, a cyst or tumour may have the same impact. Patients of multiple sclerosis could develop this condition as it damages the myelin sheath, the protective coating around the nerve, which can lead to pain. Other triggers are facial injury, stroke or a faulty dental surgery.
Once we have made the diagnosis, we have medicines to improve the nerve function of the trigeminal nerve which can give lasting relief. Most of these drugs are sodium channel blockers, meaning they block the flow of sodium ions, which are essential for generating nerve impulses that transmit pain signals to the brain.
In some patients who do not respond to medication, we do radiofrequency laser ablation, which uses heat to create a lesion on the nerve and block the pain signals emanating from it. Most patients benefit from this procedure. Sometimes we compress the nerve with a balloon to relieve the pain. We even inject glycerol to cause minor nerve damage. Then there is microvascular decompression, which is a surgical procedure to lift a blood vessel away from the trigeminal nerve to relieve pressure.
