Trigeminal Neuralgia

Overview

Trigeminal neuralgia, also called tic douloureux, is a chronic pain around the trigeminal nerve distribution on the face. It is a form of Nerve Pain. The typical or "classic" form of the disorder causes sudden, severe, irregular or shock-like facial pain that lasts anywhere from a few seconds to as long as two minutes per episode.

Signs and Symptoms

Episodes of severe, shooting or jabbing pain on one side of face (rarely both), Pain at cheek, jaw, teeth, gums, lips, or less often the eye and forehead, Pain focused in one spot or spread in a wider pattern Acute attacks of pain or attacks triggered by things such as touching the face, chewing, speaking or brushing teeth, Constant aching, burning feeling before spasm

Common Causes

Demyelination due to pressure of normal blood vessel compressing the trigeminal nerve as it exits the brain and multiple sclerosis, Brain lesions, Surgical injury, Stroke, Facial trauma

Risk Factors

Age : More then 50 years old, Asians, Female sex, Multiple sclerosis

Investigation Techniques

Neurological examination, MRI

Treatment and Prevention

Carbamazepine, pregabalin or gabapentin reduces the pain, Muscle relaxants: baclofen, Injection of alcohol or phenol into peripheral branch of the nerve, Radiofrequency to the lesion in the nerve near the Gasserian ganglion, Vascular compression of the trigeminal nerve through posterior craniotomy