Trigeminal Neuralgia (Tic Douloureux)

Trigeminal neuralgia, or tic douloureux, is a chronic neurological condition that disrupts the function of the trigeminal nerve, which transmits sensations from the face to the brain. As a result, even mild facial stimulation can trigger a sudden bout of excruciating pain.

Tampa General Hospital’s Neuroscience Institute brings together a multidisciplinary team with extensive experience in treating trigeminal neuralgia, a complex and potentially disruptive condition. Many patients who elect surgical treatment confidently entrust their care to the neurosurgeons and ear, nose and throat specialists who practice in our Skull Base Surgery Center. We work closely with each patient to create a personalized treatment plan to achieve the best possible outcome and quality of life.

What Causes Trigeminal Neuralgia?

Oftentimes, tic douloureux results from compression of the trigeminal nerve at the base of the brain. The source of the pressure may be an artery, vein or brain tumor. In some cases, the condition develops after the myelin sheath that protects the trigeminal nerve is damaged from multiple sclerosis, a stroke or facial trauma.

Trigeminal neuralgia may also run in some families, possibly due to an inherited pattern of abnormal blood vessel formation.

What Are the Symptoms of Trigeminal Neuralgia?

Type 1, or classic, trigeminal neuralgia causes spontaneous episodes of severe, shock-like pains and spasms that can last for a few seconds up to several minutes. In many cases, the attacks become more frequent and intense over time. Type 2, or atypical, trigeminal neuralgia causes constant burning or aching sensations.

Tic douloureux symptoms can occur anywhere along the path of the trigeminal nerve, possibly affecting the:

• Cheeks
• Jaw
• Teeth
• Gums
• Lips
• Eyes
• Nose
• Forehead

The symptoms may be triggered by:

• Washing the face
• Brushing the teeth
• Shaving
• Putting on makeup
• Eating or drinking
• Talking or smiling
• A breeze lightly blowing on the face

How Is Trigeminal Neuralgia Diagnosed?

Tic douloureux usually produces distinctive symptoms. To confirm the diagnosis, a physician will typically:

• Perform a neurological examination to evaluate the pain patterns
• Perform a reflex test to determine whether the symptoms stem from a compressed nerve
• Order magnetic resonance imaging (MRI) scans of the head to visualize the flow of blood through the arteries and veins and look for a brain tumor

H2: How Is Trigeminal Neuralgia Treated?

The discomfort associated with tic douloureux can often be managed with medications that reduce or block the pain signals being sent from the trigeminal nerve to the brain. Some options include:

• Anticonvulsants
• Antispasmodic agents
• Botox injections

Surgical treatment, such as microvascular decompression or brain stereotactic radiosurgery, may be considered to address severe or persistent symptoms.

Receive World-Class Care at TGH

At TGH, you can receive personalized care from some of the most skilled and experienced neurosurgeons in the world. To schedule an appointment, contact us at (800) 822-3627.