Trigeminal neuralgia (TN), also called tic douloureux, is a chronic pain condition that causes extreme, episodic, sudden burning or shock-like pain on one side of face.

The pain seldom lasts more than a few seconds or a minute or two per episode in the initial stages.

Episodes can last for days, weeks, or months at a time and then disappear for months or years.

The attacks often worsen over time, with fewer and shorter pain-free periods before they recur. The pain can be triggered by contact with the cheek (such as when shaving, washing the face, or applying makeup), brushing teeth, eating, drinking, talking, or being exposed to the wind. TN occurs most often in people over age 50, but it can occur at any age, and is more common in women than in men.

Although debilitating, the disorder is not life-threatening. The pain of trigeminal neuralgia is often falsely attributed to pathology of dental origin. Extractions do not help.

There is a variant of trigeminal neuralgia called atypical trigeminal neuralgia. In atypical trigeminal neuralgia, the sufferer experiences a severe, relentless underlying pain in addition to the stabbing pains. In other cases, the pain is stabbing and intense, but may feel like burning or prickling, rather than a shock.

Causes of Trigeminal Neuralgia

Several theories exist to explain the possible causes of this pain syndrome. Leading research indicates that it is a blood vessel - possibly the superior cerebellar artery - compressing the trigeminal nerve near its connection with the pons. Such a compression can injure the nerve's protective myelin sheath and cause erratic and hyperactive functioning of the nerve. This can lead to pain attacks at the slightest stimulation of any area served by the nerve. This type of injury may rarely be caused by an aneurysm (an outpouching of a blood vessel) or by a tumour in the cerebellopontine angle. It is also seen in patients with Multiple Sclerosis.

Treatment for Trigeminal Neuralgia

• Interventional Treatments:
  • Percutaneous Radiofrequency(RF) Ablation of Gasserian Ganglion
  • Percutaneous Glycerol Rhizolysis
  • Percutaneous Baloon Micro compression
• Surgical Microvascular Decompression (MVD)
• Gamma Knife Stereotactic Radiation Therapy