Trigeminal neuralgia

• Alternative Names

  Tic douloureux

• Causes, incidence, and risk factors

  Trigeminal neuralgia causes severe, short-lasting (only a few seconds) facial pain on the side of the affected nerve. The condition usually affects older adults.

  Often, no cause can be found. However, areas of brain swelling or abnormal blood vessels (arteriovenous malformations) can cause it.

  Painful trigeminal neuralgia attacks may occur after lightly touching areas of the face that are along the fifth skull (cranial) nerve.

• Symptoms
  • Very painful, sharp electric-like spasms that last a few seconds or minutes
  • Pain is usually only on one side of the face, often around the eye, cheek, and lower part of the face
  • Pain may be triggered by touch or sounds
  • Pain occurs while:
    • Brushing teeth
    • Chewing
    • Drinking
    • Eating
    • Shaving
• Signs and tests

  Magnetic resonance imaging (MRI) and blood tests may help rule out other conditions.

• Treatment

  Certain medicines can help reduce pain and the rate of attacks. These may include:

  • Anti-epilepsy drugs (carbamazepine, gabapentin, phenytoin)
  • Migraine medicines (sumatriptan)
  • Tricyclic antidepressants (amitriptyline, nortriptyline, or carbamazepine)

  Some patients may need surgery.

• References

  Kanai A, Saito M, Hoka S. Subcutaneous sumatriptan for refractory trigeminal neuralgia. Headache. 2006;46(4):577-582.

  Goetz CG, ed. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: WB Saunders; 2007.

Review Date: 2/13/2008

Reviewed By: Luc Jasmin, MD, PhD, Departments of Anatomy & Neurological Surgery, University of California, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.