The Most Painful Illness Known to Man

We here at The Infographics Show routinely
cover the most pressing scientific questions of our age, such as what would happen if everyone
on Earth screamed at the same time, or what if everyone went blind for 10 seconds? Occasionally we like to get silly and talk
about Link’s love life in the Legend of Zelda or taunt our favorite guinea pig by
assigning him the most ridiculous challenges – but that’s what makes our channel so
fun! And while our teams of world class researchers,
historians, and philosophers are often busy finding new, interesting topics to explore,
we absolutely love answering questions directly from you, our viewers! Today we’re going to be answering a question
asked by Kahlil, who emailed us asking about the most painful illness known to man: trigeminal
neuralgia. So, let’s get to it! The trigeminal nerve is the 5th cranial nerve
and it is the largest. This nerve is responsible for transmitting
sensory data from the face to the brain. The cause of trigeminal neuralgia is mostly
unknown, but many doctors believe it has to do with compression to the trigeminal nerve,
causing chronic, excruciating pain in the face. There are three branches of the nerve where
the pain tends to be located: the ophthalmic, located in the forehead, the maxillary in
the cheek, and the mandibular, which is located in the lower jaw. Pain typically starts in the ear and makes
its way to the jaw later. The pain can last anywhere from minutes to
hours and sometimes even days. It can make simple, mundane tasks like brushing
your teeth, shaving, or putting on makeup extremely unbearable. You can’t even smile or chew food without
triggering the distress. Sometimes even talking is impossible. The average age of diagnosis is between 50
and 80 years old with the majority of sufferers being women, though, there are many patients
diagnosed with this condition who do not fit into this category. One woman named Keshia Bush was only 25 years
old when she was diagnosed. She has been interviewed in documentaries
explaining how she cannot work or take care of her child because of the intense pain. Symptoms of the disorder tend to be very specific,
often described as a sudden onset of severe pain. Now, when we say “severe” or “excruciating”
as it relates to this condition, we are not just putting this lightly. We are referring to the type of pain that
can have you completely incapacitated. People who have gone through trigeminal neuralgia
explain it as a sharp, stabbing, shooting, almost indescribable type of pure agony. Imagine the sensation of having needles or
even knives driven into your skull. Ouch! This pain tends to be electrifying and usually
occurs on predominantly one side of the face, consistent with the area of the 5th trigeminal
nerve. Diagnosis of trigeminal neuralgia can be very
easy if you know what you are looking for, and it is usually based on the history of
the patient, which is sufficient enough to determine this condition as the problem. Unlike many other ailments, this condition
doesn’t typically require the use of elaborate tests to figure out its diagnosis. In a perfect world, the patient simply points
to the part of the face that has been causing them the distress and the doctor can tell
simply by examining which area it is coming from and attribute it to the fifth nerve. However, this condition is very often misdiagnosed
as dental pain, TMJ disorder or a couple of other similar disorders with the abbreviations
Sunct and Suna, which tend to involve edema of the eye, lacrimation and nasal congestion. Misdiagnosis usually occurs because the condition
is extremely rare with an incidence rate of about 12 cases per 100,000. For this reason, many doctors may not even
be aware of the illness. So then how is this condition treated when
the proper diagnosis for it is made? Doctors typically revert to the use of an
anticonvulsant, a medication normally given to people who have seizures. Specifically, the medication known as carbamazepine
is the preferred drug of choice for trigeminal neuralgia. If that doesn’t work, doctors may try phenytoin
or gabapentin. Because we know you’re well versed in the
complex names of pharmaceutical medications and you can probably pronounce them better
than we can, you likely know exactly what they are. Another treatment method relates to neurosurgery,
which can either be non-destructive or destructive, depending on severity. Non-destructive methods include microvascular
decompression, a fancy term to describe a procedure with which the nerve is separated
from surrounding arteries or vessels that may be causing compression. The destructive surgical method, which is
sometimes necessary, refers to causing purposeful damage to the trigeminal nerve so that it
can no longer transmit pain signals. The loss of pain signals may sound nice, but
it also involves certain consequences, such as a loss of other sensations. For instance, you may no longer be able to
feel the gentle hand of a loved one affectionately stroking your cheek. Before surgery is utilized, the patient must
have exhausted all other options and forms of treatment. Usually an MRI of the brain must first be
used as well as having a consultation with a neurosurgeon. As you can probably tell, it’s an extensive
process which can greatly wrack up your medical bill. Hopefully you have good insurance! This disease doesn’t always have a simple
fix however and it is often nicknamed “The Suicide Disease” for good reason. As mentioned at the beginning of this video,
it is the most painful condition a human can experience outside of being externally tortured. It can drive many sufferers to take their
own lives just to escape the enormity of the awful feeling. But it may not be just the pain that can push
people to consider suicide. There may also be certain social implications. For those who don’t have trigeminal neuralgia,
it may be difficult to understand why it is such an ordeal: “Pain in the face? Big deal! I go through that every time I get a root
canal or get punched in the face at my local bar.” Facial pain may not seem as bad as other,
more visible problems so others may not be able to relate or comprehend why someone can’t
function normally or go to work just because of this kind of discomfort. As a result, many sufferers may be susceptible
to ridicule. People around them might say, “Oh, you’re
just using this as an excuse not to work so you can lay around and do nothing all day.” We here at the Infographics Show would like
to remind everyone that you never know what someone might be struggling with unless you’ve
gone through it yourself, so it is best to resist jumping to judgement if you can. Still, many people can be critical of others’
circumstances, which can lead to the negative connotation of being labeled as “lazy”
if you don’t work, even if you have a valid reason for it. So not only are sufferers of trigeminal neuralgia
undergoing severe pain, but they may also feel hopeless and useless with their situation
along with the additional effects of the negative social stigma surrounding them. If you know anyone with this condition, be
kind. Perhaps understanding the extent of their
pain will help you become more sympathetic to what they are going through. Feeling freaked out after that? Still in the mood for more? Then we’ve got just the thing for you. Go watch the “Most Painful Animal Attacks
Human Could Ever Endure” right now! Compare it to trigeminal neuralgia and tell
us which you think is worse in the comments!

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