What is Trigeminal Neuralgia?Trigeminal neuralgia (TN), also called tic douloureux, is a chronic pain condition that causes extreme, sporadic, sudden burning or shock-like face pain. The pain seldom lasts more than a few seconds or a minute or two per episode. The intensity of pain can be physically and mentally incapacitating. TN pain is typically felt on one side of the jaw or cheek. Episodes can last for days, weeks, or months at a time and then disappear for months or years. In the days before an episode begins, some patients may experience a tingling or numbing sensation or a somewhat constant and aching pain. The attacks often worsen over time, with fewer and shorter pain-free periods before they recur. The intense flashes of pain can be triggered by vibration or 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. There is some evidence that the disorder runs in families, perhaps because of an inherited pattern of blood vessel formation. Although sometimes debilitating, the disorder is not life-threatening

The presumed cause of TN is a blood vessel pressing on the trigeminal nerve in the head as it exits the brainstem. TN may be part of the normal aging process but in some cases it is the associated with another disorder, such as multiple sclerosis or other disorders characterized by damage to the myelin sheath that covers certain nerves

Is there any treatment? . Because there are a large number of conditions that can cause facial pain, TN can be difficult to diagnose. But finding the cause of the pain is important as the treatments for different types of pain may differ. Treatment options include medicines such as anticonvulsants and tricyclic antidepressants, surgery, and complementary approaches. Typical analgesics and opioids are not usually helpful in treating the sharp, recurring pain caused by TN. If medication fails to relieve pain or produces intolerable side effects such as excess fatigue, surgical treatment may be recommended. Several neurosurgical procedures are available. Some are done on an outpatient basis, while others are more complex and require hospitalization. Some patients choose to manage TN using complementary techniques, usually in combination with drug treatment. These techniques include acupuncture, biofeedback, vitamin therapy, nutritional therapy, and electrical stimulation of the nerves

What is the prognosis? The disorder is characterized by recurrences and remissions, and successive recurrences may incapacitate the patient. Due to the intensity of the pain, even the fear of an impending attack may prevent activity. Trigeminal neuralgia is not fatal.

What research is being done? Within the NINDS research programs, trigeminal neuralgia is addressed primarily through studies associated with pain research. NINDS vigorously pursues a research program seeking new treatments for pain and nerve damage with the ultimate goal of reversing debilitating conditions such as trigeminal neuralgia. NINDS has notified research investigators that it is seeking grant applications both in basic and clinical pain research.

Organizations. Trigeminal Neuralgia Association 925 Northwest 56th Terrace Suite C Gainesville, FL 32605 info@fpa-support. org http://www.endthepain.org Tel: 352-331-7009 800-923-3608 Fax: 352-331-7078. International RadioSurgery Association 3002 N. Second Street Harrisburg, PA 17110 office1@irsa. org http://www.irsa. org Tel: 717-260-9808 Fax: 717-260-9809. American Chronic Pain Association (ACPA) P.O. Box 850 Rocklin, CA 95677-0850 ACPA@pacbell. net http://www.theacpa.org Tel: 916-632-0922 800-533-3231 Fax: 916-632-3208. American Pain Foundation 201 North Charles Street Suite 710 Baltimore, MD 21201-4111 info@painfoundation. org http://www.painfoundation. org Tel: 888-615-PAIN (7246) Fax: 410-385-1832. National Foundation for the Treatment of Pain P.O. Box 70045 Houston, TX 77270 NFTPain@cwo. com http://www.paincare.org Tel: 713-862-9332 Fax: 713-862-9346. Related NINDS Publications and Information Chronic Pain: Hope Through Research Chronic pain information page compiled by the National Institute of Neurological Disorders and Stroke (NINDS). Headache: Hope Through Research Information about headaches, including migraines, compiled by the National Institute of Neurological Disorders and Stroke (NINDS). Trigeminal Neuralgia: Opportunities for Research and TreatmentSummary of a workshop, Trigeminal Neuralgia: Opportunities for Research and Treatment, September 1999.