Trigeminal neuralgia, also called tic douloureux, is a common and treatable facial pain syndrome. The trigeminal nerve has three separate branches that carry sensory information from the face to the brain. Trigeminal neuralgia usually occurs when a blood vessel presses against the nerve and damages its insulation. Multiple sclerosis and skull base tumors can also damage the nerve insulation and cause trigeminal neuralgia. This damage to the insulation results in severe, stabbing, electric shock like pain in the face, coursing along the nerve.
Trigeminal neuralgia causes sudden episodes of sharp, intense facial pain that occur in brief bursts, often described as “stabbing” or “electrical shock-like” pain. Symptoms typically occur on one side of the face.
Pain can be triggered by light touch around the mouth and face, talking, brushing teeth, eating, a cold or light breeze – or even without a trigger. It stops during sleep, but often returns upon awakening.
Atypical symptoms can include constant pain with a dull or burning sensation that is not caused by a trigger.
Trigeminal neuralgia is diagnosed through a patient’s history, symptoms and a neurological examination. Imaging studies of the brain – usually a computed tomography (CT) or magnetic resonance imaging (MRI) scan – are also performed to exclude the possibility of a small tumor or the possibility of multiple sclerosis (MS).
In addition to the standard MRI scan, a special high-resolution MRI can directly visualize the trigeminal nerve and see whether a blood vessel is pressing against it.
In some patients, the pain is mild and goes away without any treatment. In others, medication can be successfully used to manage the condition for many years. Some of these medications, which are often used for controlling seizures, and can be very effective for trigeminal neuralgia. Our team will help select the best drug and dosage for you to relieve pain and minimize side effects.
If medical management is not effective or the medication side effects are excessive, other treatment may be considered: