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.
The causes are not well understood. The problem may result from:
An attack usually follows some sort of trigger. Possible triggers are:
An attack of trigeminal neuralgia often brings severe 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.
Your healthcare provider will ask about your symptoms and medical history. He or she will examine you. Tests--for example, X-rays--may be needed to rule out other causes of pain, such as infections of the teeth or sinuses. You may have an MRI scan 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.
Anticonvulsant medicines, muscle relaxants, and antianxiety medicines may help to relieve pain.
If medicine does not give relief, you may consider surgery. Several surgical techniques are being used, including removing part of the nerve. If your provider suggests that surgery may be 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. The numbness may be temporary or permanent. If you no longer have feeling in that area, you must be very careful to watch for injuries or physical problems in that area such as:
A newer treatment is radiation to the nerve. As radiation techniques have become more precise, it is 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.
The problem appears suddenly and may get better on its own. It may also disappear for months or years and then come back.
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.
There are no known ways to prevent trigeminal neuralgia.
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