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Trigeminal Neuralgia

Contact Information

(608) 263-5442

UW Health neurologists provide comprehensive treatment for trigeminal neuralgia, a chronic pain condition that affects one of the largest nerves in the head.

 

What is trigeminal neuralgia?

 

Also called tic douloureux, trigeminal neuralgia is a chronic pain condition that affects one of the largest nerves in the head (trigeminal or fifth cranial nerve). It causes attacks of extreme, sudden burning pain in the face.

 

It is a very painful disorder affecting predominately elderly individuals, although it can occur in adults of any age. This type of pain is unique because it affects only one side of the face, and it can happen as spontaneous or provoked attacks. These attacks can be very short in duration or can last for prolonged periods of time, but in either case they are disabling.

 

Trigeminal neuralgia should be differentiated from other causes of face pain, which can be due to dental, eye, ENT and neurological causes and these are excluded by medical evaluation.

 

What causes trigeminal neuralgia?

 

In some cases, the cause of trigeminal neuralgia can be identified and treatment then focused on the cause. But in the majority of patients, no clear cause can be identified. Imaging with MRI or CT scan can be helpful when investigating for possible causes.

 

One cause of trigeminal neuralgia is a blood vessel pressing on the trigeminal nerve, causing the protective coating around the nerve (called the myelin sheath) to wear away. People who have multiple sclerosis or have a brain tumor may also experience trigeminal neuralgia because both cause damage to the myelin sheath.

 

What are the symptoms of trigeminal neuralgia?

 

Trigeminal neuralgia symptoms often include sudden, severe, stabbing pain on one side of the jaw or cheek lasting anywhere from a few seconds to two minutes and come and go throughout the day. The pain can be triggered by light touch, chewing, exposure to wind, changes in temperature or for no obvious reason at all.

 

Treatment Options

  • Medical therapy: Carbamazepine and oxcarbazepine are most frequently used as first-line treatment in attempts relief the pain of trigeminal neuralgia. Additionally, medications such as baclofen and lamotrigine are used. These medications sometimes have serious side effects and need to be administered under close medical supervision. Lastly, medications that are more widely used for treatment of general pain, such as gabapentin and desipramine, may provide some relief.           
  • Open surgery
  • Percutaneous pain procedures
  • Radiofrequency Rhizotomy 
  • Stereotactic radiosurgery