It hurts to eat, drink and talk: I felt the worst pain in the world until I found a tumor

It hurts to eat, drink and talk: I felt the worst pain in the world until I found a tumor

For two years, Bruna Gasparin, 26, suffered from trigeminal neuralgia, considered one of the worst in the world. “It was a different pain than any I’ve ever felt in my life,” says the nursing technician, who has had difficulties eating, drinking, and even speaking.

On an MRI, the doctor discovered that Bruna had a 4-cm-high tumor in her brain and that it was pressing on the trigeminal nerve, which helps explain the intensity of the pain. At the age of 23, the young woman underwent surgery to remove the tumor and the pain disappeared. Bruna has already recovered, became a nursing technician at the hospital where she worked, and today she motivates other patients with her story.

“In 2017, I had severe pain, like a shock near the jaw on the left side and then in the chin. It lasted a few seconds, but it was unbearable. At first it was intermittent, I imagined it could be a muscle ache, a bad pain that hit the neck or Even a more severe headache.

In late 2018, the pain began to come and go several times during the day. I went to the dentist thinking it could be my wisdom tooth, but when it moved, the shock didn’t come and we ruled out the possibility of something related to it.

The second professional I looked up to was an ENT doctor because I thought it could be a problem with the temporomandibular joint (TMJ). On clinical examination, the doctor moved behind the joint and I felt a shock near my jaw and chin. Echo asked TMJ, but nothing came of it.

The biggest difficulty I faced was being able to describe what this pain was like knowing which specialist to look for. Over time, things got worse and started affecting simple things in my daily life.

I was shocked when chewing, drinking, talking, brushing my teeth, greeting people with a kiss on the cheek, for example. During crises I cried and cried in pain.

Photo: personal archive

I went to the emergency room several times, some doctors made some hypotheses about what it could be, but they came to no conclusion. They said it might be some chronic pain, or the pain from trigeminal neuralgia, considered some of the worst in the world, even described as worse than the pain of normal childbirth.

I went to the neurologist, and he said it’s not normal for someone my age – I was 23 – to have trigeminal neuralgia, because it’s more common in older people. He suspected two possibilities: multiple sclerosis or a tumor near the trigeminal nerve. At his request, I had a skull MRI that showed a 4 cm tumor located at a point pressing on the trigeminal nerve.

I took the test result to another neurotic who had already passed it several times. My case was surgical, he said, only removing the tumor could reduce pressure on the nerve, relieving or even stopping the pain. He gave me an urgent referral for surgery to remove the tumor and gave me an anticonvulsant, specific for my trigeminal neuralgia.

To be honest, my pain was so bad that I had no reaction when I discovered the tumor. I was so desperate when I got through the surgery, and they said it could take up to three years to come out – I couldn’t bear to live another three years with this pain.

My mother went to the city council in my city for help, they saw that she was suffering, she was mobilized and were able to speed up the process. By this time, she had stopped attending technical nursing course classes and had spent most of the day lying in bed, drowsy from the strong medications.

Bruna Gasparin, 26, suffered the worst in the world - personal archive - personal archive
Photo: personal archive

On May 30, 2019, the surgery was performed and the tumor was completely removed. After the biopsy, we found it benign, but removing it above the trigeminal nerve was critical to stopping the trauma.

In the hospital room, I was able to drink water, eat and talk to my mother without pain. It was a wonderful feeling of happiness and gratitude. Within two months, my life was back to normal and I started to follow up once a year.

I finished the course, and in April 2020, I got my first job as a nursing technician at Universitário Cajuru Hospital, in Curitiba, where I did the surgery. I work in the inpatient unit for kidney transplantation.

Overcoming my struggles since I was sick has helped me reshape the way I treat my patients and see life. The treatment and reception I received from the team when I had my surgery and entered the hospital was very important at a time when I was feeling low and frustrated.

Today, as a healthcare professional, I am empathetic and put myself in the shoes of others. I try to provide more humane care, and when I see a patient who is sad or afraid, I tell my story as a catalyst to convey hope.”

What is fifth neuritis?

Trigeminal is the name given to the cranial nerve responsible for the sensitivity (touch, heat, and pain) of the face and the chewing movements. Neuralgia is pain arising from the nerve, in this case, it is paroxysmal pain, that is, occurring from one moment to another, in one or more areas of the trigeminal nerve, caused by the actions of chewing, coughing and touching the face.

Simple chores like brushing your teeth, brushing your hair, washing your face, or even a slight breeze blowing your face can lead to horrible, painful crises.

The cause of trigeminal neuralgia is not fully understood, but some conditions, such as intracranial pressure on the trigeminal nerve by peripheral vessels, usually arterioles, have been highlighted. Other causes include viral infections, tumor lesions, multiple sclerosis, aneurysms, and alveolar involvement after tooth extraction.

The pain is similar to a shock or burning, very intense, lasting from seconds to minutes, and disappears as soon as it begins – in attacks, it can last for hours. It is confined to one or more branches of the trigeminal nerve and affects one side of the face.

Classically, it is not associated with a defect in the neurological examination, but in some cases sensory changes can be observed in the area of ​​\u200b\u200bthe affected nerve. The pain can be so severe and the attacks are so frequent that it can drive the patient to suicide.

Bruna Gasparin, 26, suffered the worst in the world - personal archive - personal archive

After surgery to remove the tumor (pictured above), Bruna had complete pain relief

Photo: personal archive

As in the case of Bruna, an intracranial tumor located near the trigeminal nerve can cause neuralgia by compressing or displacing the nerve, and tumors that arise from the trigeminal nerve itself can cause neuralgia.

The diagnosis of fifth neuritis is mainly clinical, with a detailed history of onset of symptoms, characteristics and progression of pain, along with a thorough physical and neurological examination. In suspected cases, complementary testing with electrophysiological and neurophysiological examination and cerebrospinal fluid examination is necessary.

Initially, treatment is with specific neuropathic pain medications, and this is usually sufficient in most cases. Surgery is indicated for patients whose medications have had no effect or where a specific cause of trigeminal neuralgia has been identified, such as a tumor or vascular compression.

In cases where the cause is identified, surgery can provide full recovery and relief from pain symptoms.

Source: Robinson Antonio minigoto MarquisNeurosurgeon at Kaguro University Hospital.

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