TOUR reader Hartmuth E.: On a descent on my cross bike, the handlebars were knocked out of my hands and I hit the right side of my face on a concrete slab. My cheekbone, eye socket and arch were broken on the right side. Plates were inserted and healed well. However, the trigeminal nerve was also injured and has been causing me major problems ever since: The right side of my face is numb and sensitive to cold, my right upper lip is thick and painful, chewing and biting no longer work properly. Medication for trigeminal neuralgia only helps to a limited extent - the pain always comes on suddenly. Three neurologists said that I would have to put up with it. Can you perhaps help me further?
Doz. Dr Dr Volker Thieme: The trigeminal nerve is very often affected by a zygomatic fracture. A total of three branches run from its root at the side between the ear and eye: to the forehead, upper jaw and lower jaw. From there, they conduct sensitive sensory impressions to the brain, which is why pain in this nerve region is perceived as very strong. In your accident, one of the three branches has probably been crushed or torn, resulting in chronic damage caused by the accident. Experts refer to this as trigeminal neuropathy. Typical symptoms are sudden pain and sensory disturbances as well as sensitivity to temperature - as you describe. To alleviate the symptoms, you should consult a pain therapist in addition to a neurologist, who will not only draw up a personalised medication plan, but also provide helpful tips for everyday life. In a pain clinic, for example, you will learn how to relax and reduce stress. This will make it easier for you to deal with sudden symptoms. I also advise you to lead a generally healthy lifestyle, including continuing to cycle - as far as the pain allows.
