HealthyCanada.com

Trigeminal neuralgia (TN), also known as tic douloureux (painful spasm), is an extremely rare condition that affects 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. TN produces excruciating, lightning strikes of facial pain, typically near the nose, lips, eyes or ears. Trigeminal neuralgia is not fatal, but it is considered to be the most painful affliction known to medical science. The disorder is more common in women than in men and rarely affects anyone younger than 50.

Some cases of TN appear to be inherited, but researchers do not know for certain what causes the disorder. Some suspect it is a result of compression of the trigeminal nerve as it enters the brain stem, perhaps from plaque that builds up as we age. Other possible causes include the destruction of the protective myelin sheath that surrounds nerve fibres, physical damage to the nerve caused by surgery or dental procedures or an injury to the face. Psychological stress may also be the cause as well as the outcome of TN.

Trigeminal neuralgia is characterized 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.

Treatment

Treatment for trigeminal neuralgia typically includes anticonvulsant medications such as carbamazepine or phenytoin. Baclofen, clonazepam, gabapentin, and valproic acid may also be effective and may be used in combination to achieve pain relief. If pain becomes more frequent and severe, increased doses of medications are required. This may lead to intolerable side effects and/or inadequate pain control. If medication fails to relieve pain, surgical treatment may be recommended. However, because of the risks of brain surgery, this is always considered as a last option for most TN patients.