Trigeminal Neuralgia (TN) is a disorder of the trigeminal nerve, which is the fifth and largest cranial nerve. TN is characterized by sudden, severe, electric shock-like ,or stabbing pain, typically felt on one side of the jaw or cheek. TN is uncommon, with an estimated prevalence of 155 cases per million persons. For the most part, TN strikes people over the age of 50, although isolated pediatric cases have been documented.
TN can be either idiopathic or secondary. Secondary TN may be caused by a tumor, a number of vascular abnormalities, inflammatory disorders like MS, or possibly due to the remote effects of cancer.
Trigeminal Neuralgia: Symptoms
The primary symptom of Trigeminal Neuralgia is sudden, severe and stabbing pain experienced on one side of the face. Attacks generally last several seconds and may occur in quick succession, coming and going throughout the day and sometimes lasting for days, weeks, or months at a time, and then disappearing abruptly. The pain may provoke brief spasm of the facial muscles, producing wincing or a tic. For this reason, the disorder is also known as “tic douloureaux.”
Simple activities such as shaving, washing the face, or chewing can trigger an episode. In fact, stimuli as mild as a light breeze may provoke pain in some patients.
Trigeminal Neuralgia: Diagnosis
There is no test to detect Trigeminal Neuralgia. TN is diagnosed almost entirely by the symptoms the patient describes and by ruling out other sources of facial pain. In fact, patient history is the most important factor in the diagnosis of TN. The results of a standard neurological physical exam are typically normal in patients with TN.
If your doctor suspects you have TN, he or she may request a magnetic resonance imaging (MRI) scan to rule out multiple sclerosis or a tumor as a cause of the pain.
Trigeminal Neuralgia: Treatment
Trigeminal Neuralgia is initially treated with anticonvulsants – the most effective of which is carbamazepine. Other medications that may benefit some patients include phenytoin (Dilantin), baclofen, gabapentin (Neurontin), Trileptol and Klonazepin.
Surgical treatment is also an option if medications become ineffective or the associated side-effects become intolerable. Surgical options include:
- Peripheral nerve blocks or ablation
- Craniotomy followed by microvascular decompression (MVD)
- Gamma Knife® Stereotactic radiosurgery
Trigeminal Neuralgia: Resources
The Facial Pain Association (formerly The Trigeminal Neuralgia Association)
925 NW 56th Terrace, Suite C
Gainesville, FL 32605-6402
Tel: 800-923-3608 or 352-331-7009