Facial Pain

Trigeminal Neuralgia (Tic Douloureux)

Trigeminal neuralgia is a general term referring to facial pain caused by a disturbance of the Trigeminal nerve ( V cranial nerve). There are many causes of trigeminal neuralgia with variable patterns of facial pain. Tic Douloureux is a specific form of trigeminal neuralgia with a unique pattern of pain. The trigeminal nerve has three branches that go to the forehead, cheek and jaw, and the painful condition can exist in one or all of these areas.

Symptoms:

The pain consists of intermittent episodes of severe facial pain, lasting anywhere from a few seconds to a few minutes, with periods of no pain at all. The pain can be elicited by facial stimulation, chewing or talking, or may occur spontaneously.

Causes:

Several known causes exist, including small, benign tumors that compress the nerve adjacent to the brain stem; Multiple Sclerosis (usually in younger patients); or simply changes in the arterial positioning that are a natural part of aging. As our arteries become more elongated and meandering with age, the superior cerebral artery can begin to impinge on the 5 th cranial nerve. In these cases a procedure known as Microvascular Decompression (MVD) can be beneficial, with the advantage of preserving facial sensation. Other techniques include various methods by which the nerve is partially damaged to stop the painful transmissions. Radiosurgery is now an option for treatment of Tic Douloureux, and has had excellent success.