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Trigeminal Neuralgia

What is trigeminal neuralgia?

Trigeminal neuralgia is nerve pain in the face, teeth, mouth, or nose. Attacks of pain may occur on one 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.

How does it occur?

The causes are not well understood. The problem may result from:

  • irritation of nerves that sense pain and touch
  • multiple sclerosis
  • infection of the nerve by the herpes simplex virus.

An attack usually follows some sort of trigger. Possible triggers are:

  • a light touch to the area
  • brushing teeth
  • chewing or swallowing
  • exposure to hot or cold air or drinks.

What are the symptoms?

An attack of trigeminal neuralgia often brings stabbing or burning pain that comes in sudden jabs. The pain may last 1 to 15 minutes. The most common areas of attack are the cheeks and jaw. The frequency of the attacks varies from person to person. Between attacks, most people do not have pain, but some may have a dull ache.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history. He or she will examine you. Tests may be needed to rule out other causes of pain, such as infections of the teeth or sinuses. You may have a magnetic resonance imaging scan (MRI) to check for multiple sclerosis or a tumor as a cause of the pain. Your provider may refer you to a neurologist or neurosurgeon for more tests.

How is it treated?

Anticonvulsant medicines, muscle relaxants, and antianxiety medicines may help to relieve pain.

If medicine does not provide relief, you might consider surgery. Several surgical techniques are being used, including removing part of the nerve. If surgical evaluation indicates that surgery is a good option for you, find a surgeon who is experienced in the procedure recommended for you.

After surgery, the affected area may be numb. Because you may no longer have feeling in that area, you must be very careful to watch for injuries or physical problems in that area such as:

  • burns
  • dry eyes (when the blink reflex has been lost)
  • chewing-related problems, including gum and other dental problems.

A newer treatment is radiation to the nerve. As radiation techniques have gotten more precise, it has become possible to deliver radiation to just a small area of a nerve. You can ask if this treatment option is available in your area.

Some people may find pain is reduced or relieved by acupuncture, chiropractic adjustment, self-hypnosis, or meditation.

How long will the effects last?

The problem appears suddenly and may get better on its own. It may also disappear for months or years and then come back.

How can I help take care of myself?

Keeping a pain diary may help you to see which activities or conditions cause your pain. Then you will know what you need to avoid.

Treating pain at the very first symptom may keep it from becoming as severe, and the pain may last a shorter time.

How can I help prevent trigeminal neuralgia?

There are no known ways to prevent trigeminal neuralgia.

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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.

HIA File neur3433.htm Release 13/2010

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