What Is Trigeminal Neuralgia?

Trigeminal neuralgia (tic douloureux) is a disorder of the fifth cranial (trigeminal) nerve that causes episodes of intense, stabbing, electric shock-like pain in the areas of the face where the branches of the nerve are distributed - lips, eyes, nose, scalp, forehead, upper jaw, and lower jaw.

Classic symptoms of Trigeminal Neuralgia include:

• Pain is described as lancinating - (sharp)
• Pain comes and goes (intermittent)
• Pain must be in the distribution of the trigeminal nerve
• There has to be triggers
• There is remission
• A diagnostic tool is the response to Tegretol (Carbamazepine)

Trigeminal nerve - (V) fifth cranial nerve

V1: Ophtalmic-eye, forehead and nose.^1-Sensory
V2: Maxillary - upper teeth, gums and lip, the cheek, lower eyelid and the side of the nose.^1-Sensory
V3: Mandibular - lower teeth, lower gums and lower lip.^1-Sensory
                         - Jaw.^2-Motor

¹SENSORY: Transmits pressure, touch, pain and temperature signals to the brain.
²MOTOR: Controls movement.

Trigeminal Neuralgia pain can involve one or more branches of the trigeminal nerve.

A valuable clue to the diagnosis is the triggering of the pain with certain activities. Patients carefully avoid rubbing the face or shaving a trigger area.

Chewing, talking, smiling, or drinking cold or hot fluids may trigger Trigeminal Neuralgia pain. Touching, shaving, brushing teeth, blowing the nose, or cold/warm breeze also may bring on an attack.