Trigeminal neuralgia (TN), also known as tic douloureux, is a condition in which the trigeminal nerve becomes compressed, usually by a blood vessel. The pressure on this nerve—which carries sensation from the face to the brain—results in a shock of intense pain when the face is stimulated (e.g., smiling, brushing teeth, eating or drinking). The pain can last from several seconds to several minutes.
In addition to pressure from a blood vessel, TN may also be due to:
In addition to the bouts of severe pain upon face stimulation, symptoms can include:
Diagnosis is mainly based on the patient’s description of pain, including type, location and triggers.
Sometimes, tests may also be performed to confirm a TN diagnosis. These include a thorough neurological examination, a magnetic resonance imaging (MRI) scan (to see if there’s an underlying cause, such as a tumor) or a reflex test.
TN is usually managed with medication—such as anticonvulsants, muscle relaxants (antispasmodic) or Botox injections—to reduce or block the pain signals to the brain. In some cases, however, medication can become less effective over time or cause unpleasant side effects.
Should medication fail, surgery may become the next viable option to relieve pain and other symptoms of TN. Surgical procedures include:
The goal of MVD is to relocate or remove the blood vessel(s) pressing on the nerve. During an MVD, the physician makes a small incision behind the ear, then moves the arteries away from the nerve and places a pad between the two. If a vein is causing the compression, it may simply be removed during the procedure.
Stereotactic radiosurgery is a noninvasive therapy that allows the physician to target a specific spot with radiation. In the case of TN, it is aimed at the root of the nerve in order to damage it, resulting in the elimination or gradual reduction of pain.
During a rhizotomy, a surgeon destroys the nerve fibers in the face, resulting in some numbness. Types of rhizotomy include:
For more information about trigeminal neuralgia or to schedule an appointment with a specialist, contact us today.