The Pain Behind The Smiles: Triple Threat Few Know Anything About
New Delhi: In a startling revelation on The Great Indian Kapil Show, actor Salman Khan revealed a harrowing truth that belied his trademark smile and action-packed persona. The 59-year-old Bollywood star disclosed that he suffered from three life-altering neurological and vascular conditions: trigeminal neuralgia (TN), brain aneurysm and arteriovenous malformation (AVM).
The disclosure was as stunning as it was sobering. Though Khan underwent surgery for trigeminal neuralgia in Los Angeles in 2011, he continues to live with the burden of the remaining diagnoses. Yet, defying medical odds and excruciating pain, the veteran actor remains active, often charging through intense action sequences.
TN, often described as 'the suicide disease' due to its unbearable pain, causes sudden, shock-like stabs on one side of the face, usually around the eyes or mouth.
The condition, which can be triggered by cold water, cold air or touching specific facial areas called trigger points, is notorious for its debilitating effects. While TN isn't lethal, it severely impacts quality of life and mental health.
A brain aneurysm, meanwhile, is a ticking time bomb, caused by a weak spot in a cerebral blood vessel that balloons dangerously, threatening to burst at any moment. AVM, a rare and complex condition, involves a tangled web of abnormal blood vessels that bypass the normal capillary system, directly connecting arteries to veins, raising the risk of catastrophic bleeding.
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Dr Anshu Rohatgi, vice-chairperson, neurology, Sir Ganga Ram Hospital, explained that severe cases could present with intense headaches and sub-arachnoid haemorrhage could potentially lead to limb weakness or unconsciousness.
Dr P Sarat Chandra, senior neurosurgery professor, AIIMS, added, "Brain aneurysm and AVMs are potentially fatal. If the blood vessels rupture, the consequences can be stroke, irreversible brain damage, even death."
Khan's situation is particularly complex due to potential interactions between these conditions. Medical professionals note that aneurysms or AVMs pressing against the trigeminal nerve may intensify neuralgia symptoms. These conditions aren't directly connected.
Dr Pooja Anand, associate consultant neurology, Paras Healthcare, Gurgaon, noted that while these illnesses have different causes and mechanisms, vascular abnormalities are common to both aneurysms and AVMs and their coexistence could potentially affect nearby nerves.
Regarding causation, Dr PN Renjen, senior consultant, neurology, Indraprastha Apollo Hospitals, explained that these conditions occasionally influence each other. An AVM might affect blood flow patterns, causing aneurysm formation. Both conditions, when near the trigeminal nerve, could cause neuralgia, though TN doesn't cause the other conditions.
Dr Sandhya Koche, principal consultant, neurology, Sri Balaji Action Medical Institute, explained that although uncommon, the concurrent presence of these three conditions is medically feasible, typically resulting from vascular irregularities affecting multiple brain regions.
She pointed out that an arteriovenous malformation could lead to both trigeminal nerve complications and aneurysm development.
"In addition, patients may experience separate aneurysms or nerve disorders, particularly if they have risk factors, including hypertension, inherited vascular disorders or previous head injuries. Though rare, when these conditions occur together, they highlight the intricate nature of cerebrovascular and neural health, necessitating thorough diagnostic imaging and coordinated care from multiple specialists," said Koche.
C
handra outlined various treatment options, often customised for individual patients. Microvascular decompression surgery offers effective treatment, while Gamma knife provides a non-invasive alternative, though pain relief may take longer. Aneurysms and AVMs may require surgery, neuro-intervention. Gamma knife treatment could work for AVM only, depending on patient factors and condition severity.
"Large aneurysms might need bypass procedures. Neuro-intervention has become increasingly viable, though complete elimination of conditions isn't guaranteed. Complex cases may require combined treatments," he said.
Dr Sweta Singla, senior consultant, neurology, Narayana Hospital, Gurgaon, emphasised ongoing medical monitoring through advanced diagnostics and lifestyle modifications. Treatment requires strict medication adherence, avoidance of triggers and prompt attention to warning signs. Risk management includes controlling blood pressure and avoiding smoking and stress.
So, behind the glamour of his stardom, Salman Khan is locked in a daily duel with pain and peril. His persistence is not just about celebrity — it is survival.
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