Trigeminal Neuralgia

Introduction

Trigeminal neuralgia (TN) is a disorder of unilateral (usually right-sided) facial pain. While the exact cause is unknown, it is thought that TN results from irritation of the trigeminal nerve. This irritation results from damage due either to changes in the blood vessels or the presence of a tumor or other lesions that cause compression of the nerve.

The first symptoms of TN most commonly occur in persons over the age of 50, and affect women more often than men.

The pain of TN is characterized by unilateral pain attacks that start abruptly and last for varying periods of time from minutes to hours. The pain quality is usually sharp, stabbing, lancinating (cutting or tearing), and burning. It may have an "electric shock"-like character. The attacks are initiated by stimuli such as light touch of the skin, chewing, washing the face, and brushing the teeth. In some individuals the attacks may be initiated by non-painful physical stimulation of specific areas (trigger points or zones) that are located on the same side of the face as the pain.

Medical treatment is often very effective in controlling pain symptoms. In fact, the anti-seizure drug carbamazepine is so effective initially that the lack of response often calls into question the accuracy of the diagnosis.

For persons with continued pain after medical therapy, surgical options may be considered. These procedures have variable risks but may be very effective.

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