Trigeminal neuralgia

The trigeminal nerve carries sensation from the face, teeth, mouth, and nasal cavity. Trigeminal neuralgia means nerve pain in one or more of these areas. It may occur on either or both sides of the face. Trigeminal neuralgia is also called tic douloureux.

Trigeminal neuralgia occurs most often in women over age 40, although it may occur in men or women of any age. The problem appears suddenly and may resolve on its own. It may also disappear for months or years, only to return.An attack of trigeminal neuralgia often brings searing or burning pain that comes in sudden jabs. This may last from 1 to 15 minutes. The most common areas of attack are the cheeks and jaw.

An attack usually follows some sort of trigger. These may include:

• a light touch to the area or
• exposure to hot or cold air or drinks

The frequency of the attacks varies from person to person. Between attacks, most people are free of pain. Some may have a dull ache. The causes are not well understood. The problem may result from:

• a short circuit between touch and pain nerves
• multiple sclerosis or
• infection of the nerve by herpes simplex virus

Trigeminal neuralgia produces no clinical changes that can be measured. Therefore, the person's symptoms may be used to diagnose it. The person may favor the area of the face by trying to hold it still. He or she often stops washing and shaving the area and may keep it covered. Tests may be needed to rule out other causes of pain such as tumors or infections of the teeth or sinuses.

Certain medicines may relieve the pain. When medical measures fail, one might consider surgery. There are methods to remove part of the nerve. These include electrosurgery, microsurgery, and radio wave surgery.

After surgery, the affected area will lose the pain and its sense of touch. The patient must be very careful to watch for future physical problems that are usually signaled by pain, such as:

• burns
• dry eyes (when the blink reflex has been lost) and
• chewing-related problems and gum and dental problems (when oral sensation has been lost)

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIL File NEUR3539.RF2 VRS# 5514 Data Version 7.0 Copyright 1998, 2000 McKesson Health Solutions LLC. All rights reserved.