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Correct Diagnosis & Treatment Can Help Cure the Winking Disease
Getting over the ‘suicide disease’ and winking disease is possible with the correct diagnosis and treatment and if operated by the right team – Dr Jaydev Panchawagh, Neurosurgeon, Sahyadri Hospitals.
Trigeminal neuralgia is a disorder of the fifth cranial nerve, the trigeminal nerve. With blood vessels pressing against the trigeminal nerve, the condition leads to unbearable pain on the face, cheek, and one side of the face, generally on the upper side of the chin and upwards and backward until the ear level. The progressive disorder worsens due to the elongation of blood vessels and subsequent crowding near the nerves and folding in a limited space.
This causes hitting pulsation, which destroys myelin, an insulating layer around the nerve. The character of this myelin changes at and around the region where the nerve enters the brain. One or more blood vessels compressing in this zone can cause trigeminal neuralgia. This can happen either due to age, in some cases due to genetic structures or in rare cases due to tumour and Multiple sclerosis.
The worrying characteristics of this disease include excruciating pain like an electric shock or piercing knife, multiple needles, red chilli powder on the face, etc.
Another similar disorder in which one side of the face twitches repeatedly is called hemi facial spasm (HFS). In this disorder, one side of the person’s face repeatedly contracts. It usually starts in the muscles surrounding the eye. For an observer, it seems the person is repeatedly winking with that eye and making gestures, which creates an embarrassing situation.
The diagnosis involves understanding the typical features of the pain and where and when it occurs. The face becomes extremely sensitive to touch, lower temperature or even light breeze created by household fans. Even the process of chewing or eating can become unbearable. The intense pain depletes the patient’s morale and can push a person into suicidal thoughts, which is why it is called a ‘suicide disease’.
The disease causes behavioural changes. The patients start to stay aloof because of pain or muscle contractions. The patient’s reaction to the pain, such as putting a hand on the side of the pain or winking of eyes, makes the observers feel that there might be some physiological issue. This may push the patients into social aloofness and overall depletion in quality of life.
The key to diagnosing the disease is understanding the clinical history and description of the pain. This has to be backed up with MRI, including a specific CISS–nerve sequence. The only treatment for this condition is microvascular decompression ( MVD ) surgery.
When the disease starts, surgery may not be advised. Initially, a small numbing dose of medication may be given. It needs to be seen whether the disease is evolving. If the pain intensity increases, then the MVD procedure is advised. The timeline between the onset of pain and the increase in intensity varies in different cases. Sometimes, facial pain can lead to a wrong diagnosis, resulting in dental procedures and triggering pain.
FAQs
What is winking disease? Winking disease, or Bell’s palsy, causes temporary facial paralysis, often affecting one side of the face.
What are the causes of winking disease? It may result from viral infections like herpes, inflammation of facial nerves, or autoimmune responses.
What are the common symptoms of Bell’s palsy? Sudden weakness or drooping on one side of the face, drooling, and difficulty closing the eye.
Is Bell’s palsy curable? Most cases resolve within weeks to months with treatment like physical therapy, steroids, or antiviral medication.
When should I seek medical help for facial paralysis? Immediate consultation is needed to rule out severe conditions like strokes or other neurological disorders.
