Trigeminal Neuralgia (TN) or tic douloureux is a chronic, debilitating condition characterized by intermittent, intense and excruciating one-sided facial pain. The pain is periodical and episodic which lasts from a few seconds to several minutes. The Trigeminal nerve is the largest cranial (head) nerves which radiates to ophthalmic, maxillary, and mandibular. Most commonly the maxillary and/or mandibular branch is involved. It sends impulses of touch, pain, pressure, and temperature to the brain from the face, jaw, gums, forehead, and around the eyes.
Causes of Trigeminal Neuralgia:
- Compression of the trigeminal nerve by an adjacent blood vessel
- Demyelination (loss of nerve covering) of the trigeminal nerve
- Stress and anxiety
- Genetic tendency
- Tumor and Multiple Sclerosis (in rare cases)
- Unknown causes
Diagnosis of Trigeminal Neuralgia
Trigeminal neuralgia is recognizable by patient history alone and is diagnosed by his description of the symptoms. Magnetic resonance imaging (MRI) can be used to determine whether a tumor or multiple sclerosis is irritating the trigeminal nerve. MRI is performed to rule out other causes of compression of the trigeminal nerve such as mass lesions, large ectatic vessels, or other vascular malformations. Otherwise, no test can determine with certainty the presence of trigeminal neuralgia.
Symptoms of Trigeminal Neuralgia
Trigeminal Neuralgia presents itself as facial pain and headache which is sudden, sporadic, electric shock-like and intensely agonizing. Depending on which part of the nerve is affected (ophthalmic, maxillary, and mandibular) the symptoms will be experienced in those areas. Skin contact (shaving or washing), brushing teeth, oral intake, exposure to wind, etc can trigger the pain. Patient is usually pain-free in between the attacks of TN.