Trigeminal Neuralgia

Trigeminal Neuralgia

(Tic douloureux)

Trigeminal neuralgia is a type of nerve pain that affects your face. You may feel an intense burst of pain in part of your face, usually one side of the jaw or cheek. The pain may be burning or sharp and so severe that you can’t eat or drink.

A flare-up begins with tingling or numbness in the area. Then pain starts to come and go, often in bursts that last anywhere from a few seconds to two minutes. During a flare of the condition, these bursts of pain may become more and more frequent until the pain almost never stops. Although the intensity of the pain can make it hard to get through your day, it’s not life-threatening.

This chronic pain condition can flare up for a few weeks or months. Then the pain disappears for a while, sometimes years.

Facts about trigeminal neuralgia

This pain condition happens most often in people older than 50, though younger people can also experience it. Trigeminal neuralgia is more common in women than men. The condition may run in families.

Pressure on your cheek, such as from a razor when shaving or from your fingers when applying makeup, can trigger the pain. Brushing your teeth, standing in the wind, washing your face, eating, drinking, and even talking also may cause it.

Experts think that a blood vessel pressing against the trigeminal nerve triggers the pain. Sometimes multiple sclerosis or, rarely, a tumor causes the pain.

Symptoms

People with trigeminal neuralgia may experience these symptoms:

  • Tingling or numbness in the cheek or jaw

  • Dull aching in the cheek or jaw

  • Flashes of severe pain in the cheek or jaw

  • Anxiety from the thought of the pain returning

Diagnosis

To diagnose trigeminal neuralgia, your doctor will typically take your medical history and do a physical exam. Giving your doctor details of the pain, such as where and when it occurs, may help with making a diagnosis. Imaging tests might be used to try to rule out other causes of pain.

Treatment

Most common over-the-counter and prescription pain medications don’t work for people with this condition. Treatment for trigeminal neuralgia may include:

  • Anticonvulsant medication

  • Tricyclic antidepressants

  • Surgery, if medication has failed

  • Acupuncture

  • Biofeedback

  • Electrical stimulation of the nerves

  • Changes in diet

  • Vitamins

Prevention

Experts don’t know how to prevent trigeminal neuralgia. You may learn to avoid certain activities that seem to trigger the pain more than others.

Managing trigeminal neuralgia

Although not fatal, the pain and anticipation of the pain can interfere with your life. Working closely with your doctor will help you find the best pain management approaches for you. Alternative therapies, such as acupuncture and biofeedback have also been shown to help.