Trigeminal neuralgia

Summary

  • Trigeminal neuralgia is also called Tic Douloureux.
  • It is a condition that affects the trigeminal nerve (the 5th cranial nerve), one of the largest nerves in the head. The trigeminal nerve is responsible for sending impulses of touch, pain, pressure and temperature to the brain from the face, jaw, gums, forehead and around the eyes.
  • Trigeminal neuralgia is characterised by a sudden, severe, electric shock-like or stabbing pain typically felt on one side of the jaw or cheek.
  • The attacks of pain, which generally last several seconds and may be repeated one after the other, may be triggered by talking, brushing teeth, touching the face, chewing or swallowing. The attacks may come and go throughout the day and last for days, weeks or months at a time and then disappear for months or years.

Prevalence

The disorder is more common in women than in men and rarely affects anyone younger than 50.

Prognosis

The disorder is characterised by recurrences and remissions. Successive recurrences may incapacitate the patient. Due to the intensity of the pain, even the fear of an impending attack may prevent activity. Trigeminal neuralgia is not fatal.

Treatment

Treatment typically includes anticonvulsant medications such as carbamazepine or phenytoin. Baclofen, clonazepam and valproic acid may also be effective and may be used in combination to achieve pain relief. If medication fails to relieve pain, surgical treatment may be recommended.

Reviewed by Dr Andrew Rose-Innes, MD, Department of Neurology, Yale University School of Medicine, New Haven.

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