Overview
Trigeminal neuralgia, also called tic douloureux, results in severe pain. The disorder affects one of the cranial nerves, the trigeminal nerve, which begins at the base of the brain. The patient has an episode of pain that occurs in the face, which can last between a few seconds to two minutes, according to the National Institute of Neurological Disorders and Stroke (NINDS). The pain differs among patients, depending on the type of trigeminal neuralgia they have.
Causes
No cause of trigeminal neuralgia is known for many patients, according to MedlinePlus. But for other patients, it is thought to be due to a blood vessel putting pressure on the nerve as it comes out of the brain stem. The pressure from the blood vessel causes deterioration of the myelin sheath, which covers the nerve and helps with neural communication. Trigeminal neuralgia can also occur with multiple sclerosis, another disorder with myelin sheath deterioration.
Triggers
The Mayo Clinic states that certain triggers can cause the pain of trigeminal neuralgia to start, particularly triggers that involve the patient touching his face. Examples of triggers include shaving, stroking of the face and putting on makeup. Other actions that may trigger symptoms of trigeminal neuralgia are smiling, eating, drinking, talking and brushing your teeth. Even a passing breeze can start up symptoms in some patients.
Symptoms
The hallmark symptom of trigeminal neuralgia is pain. A patient with type 1 trigeminal neuralgia has sharp pain more than 50 percent of the time, and a patient with type 2 trigeminal neuralgia has aching or burning pain more than 50 percent of the time, according to NINDS.
Occurrence
Although a person of any age can have trigeminal neuralgia, NINDS notes that the disorder is more common in women and in people over age 50. Trigeminal neuralgia may be a genetic disorder, since the shape of the blood vessel plays a role in putting pressure on the nerve.
Treatment
Medication is the treatment of choice to help with the pain and frequency of attacks. Options include migraine medications, anticonvulsants and tricyclic antidepressants. Sumatriptan is an example of a migraine medication. Anticonvulsant options includes phenytoin, carbamazepine and gabapentin. Tricyclic antidepressants, an older type of antidepressant, that treat trigeminal neuralgia are amitriptyline and nortriptyline. Surgery is another option for patients. The two surgeries used for trigeminal neuralgia are rhizotomy and microvascular decompression.
About this Author
Lia Stannard has her Bachelor of Science degree in neuroscience with an emphasis on neuropsychology. She is a certified sexual assault crisis counselor. She has presented her research in memory at several national conferences. Stannard has been a freelance writer for more than five years, covering women’s health, politics and medicine.
