Trigeminal Neuralgia or Tic douloureux

Trigeminal neuralgia (also called "tic douloureux" or "tic dolorosa") is a facial pain syndrome consisting of sharp, "lancinating" or stabbing pain in the face. The pain is often described as shock-like stabs of pain. The pain is only on one side of the face and may be elicited by touching trigger points in the skin of the gums. There is no associated numbness (unless there is co-existing multiple sclerosis, see below). Often there may spontaneous remissions from pain lasting weeks to years. This pain usually responds to the drug carbamazepine (Tegretol^®), an oral anticonvulsant medication.

Trigeminal neuralgia is usually caused by compression of the main facial sensory (Trigeminal) nerve within the skull by a small artery or vein at the point where the nerve joins the brain stem. Sometimes a small, benign tumor compresses the nerve, causing jolts of electrical shock-like pain to radiate into the face. A few percent of tic douloureux patients suffer from multiple sclerosis. In this case the inflammatory response affecting the brain also involves the trigeminal nerve, causing the paroxysmal pain. Treatment of both conditions can provide relief.