Trigeminal neuralgia (sometimes called tic douloureux) is a condition that causes persistent pain in a specific region of the face. It occurs when one or more branches of the trigeminal nerves (the nerves in the face) become irritated or inflamed. The trigeminal nerves are located on each side of the face and feature three branches:
Trigeminal neuralgia can affect any of these branches. In most cases, pain and other symptoms occur on only one side of the face, but in bilateral trigeminal neuralgia, both sides of the face can be affected.
The most common symptom of trigeminal neuralgia is pain which can be quite severe and can occur suddenly. Pain can last for several minutes and can recur at any time, often being triggered by simple activities like brushing the teeth, shaving, face washing or putting on makeup. A gentle touch or even a light breeze can trigger painful sensations. Attacks can happen several times each day and typically are followed by a period (called remission) when no pain occurs. While sudden, severe pain is most common in people with trigeminal neuralgia, atypical neuralgia can cause intense but continual aching and burning sensations. Many patients with trigeminal neuralgia are affected by chronic anxiety as a result of their ongoing pain.
Treatment typically consists first of medication to relieve nerve irritation or relax the facial muscles, along with a special kind of antidepressant to help relieve pain. When medication is not effective in providing relief, surgery can be performed to remove the nerve or destroy specific areas of the nerve that are causing painful symptoms. Surgery can be performed using traditional techniques or radiosurgery techniques that rely on radiation and do not use incisions. The approach used will depend on the part of the nerve that’s affected, the cause of nerve irritation and as other factors.