Trigeminal neuralgia (TN), also known as tic douloureux, is a distinctive facial pain syndrome that may become recurrent and chronic. It is characterized by unilateral pain following the sensory distribution of cranial nerve V (typically radiating to the maxillary or mandibular area in 35% of affected patients) and is often accompanied by a brief facial spasm or tic. See the image below.
There are two separate trigeminal nerves, one on each side of the face. These nerves are responsible for carrying the sensation of pain and other sensations from the face to the brain. Each nerve has three branches (forehand, midface, and chin). It’s possible to have TN of any (or all) branches. TN causes intense pain in part or all of the face.
The pain can be brought on by mild stimulation of the face, such as brushing your teeth or shaving. It’s often described as feeling like electric shocks or stabbing. People with TN may initially have short, mild instances of pain, but over time they may experience longer, more frequent attacks of intense pain. Most people with TN experience symptoms in cycles — pain comes and goes for days or weeks, then subsides. In some cases, the condition becomes progressive and pain is always present.
There is no specific test for TN, so diagnosis can take time. Treatment depends on the cause and severity of the condition. Several medications are available to provide relief from pain and to decrease the number of episodes. Sometimes surgery is required.
Symptoms of Trigeminal Neuralgia
The pain of TN can come in sharp spasms that feel like electric shocks. Pain generally occurs on one side of the face and may be brought on by sound or touch. Pain can be triggered by routine acts, including:
- brushing your teeth
- shaving
- putting on makeup
- touching your face
- eating or drinking
- speaking
- a breeze on your face
You may experience bouts of pain that last only a few seconds or minutes. A series of attacks can last days, weeks, or months, followed by periods of remission.
The condition can progress, with attacks increasing in severity and frequency. In some cases, the pain or ache becomes constant.