What Is...Trigeminal Neuralgia?

January 21, 2010

Author: Catherine M. Callery (Kate)| Louise M. Tarantino

Trigeminal neuralgia is characterized by sudden and intense facial pain that is often mentally and physically debilitating. The condition is most commonly found in women over age 50, and can be seen in patients with multiple sclerosis.

The trigeminal nerve sends facial sensations to the brain. Trigeminal neuralgia, also called tic douloureux, is a malfunction of that nerve that causes horrific attacks of facial pain.  The attacks last from a few seconds to 10 minutes, and occur daily, every few days or at longer intervals.  People suffering from this malady, however, are always on the edge of their seats, waiting for the next jolt of pain.  A gentle breeze on the cheek, washing the face, shaving, brushing the teeth, eating, talking and hundreds of other innocuous stimuli can trigger paroxysms of pain.

Generally the first course of treatment is medication. Tegretol, Lioresal, and Neurontin have all been used for treatment.  Over time, however, medications may lose their effectiveness.

Patients may also consider surgery, microvascular decompression of the nerve. In most sufferers, the cause of pain is a pulsating artery that encircles the trigeminal nerve.  The artery's pulsations stimulate the painful attacks.  A neurosurgeon can place spongelike material between the artery and nerve to stop the stimulation.  Stereotactic radiosurgery (a highly precise form of radiation therapy) is another option.

This impairment was recently featured in a story on National Public Radio: http://www.npr.org/templates/story/story.php?storyId=120140173.  Even Dr. Donohue recently addressed this disorder: see http://www.detnews.com/article/20100108/OPINION03/1080315/Stabbing-face-pain-likely-due-to-nerve-disorder#ixzz0ciaXQLXC.

More information is available at the Facial Pain Association, www.fpa-support.org.