What is "trigeminal neuralgia"

n. A neuropathic disorder of one or both of trigeminal nerves leading to intense pain in parts of the face.

n. intense paroxysmal neuralgia along the trigeminal nerve [syn: tic douloureux]

Trigeminal neuralgia (TN, or TGN) is a severe neuropathic chronic pain disorder affecting the trigeminal nerve (also known as the fifth cranial nerve: a three-branched nerve that carries sensations from the face to the brain and controls facial motor functions such as biting and chewing). Evidence indicates that TN is caused by loss of myelin from the sensory fibers within the nerve root itself. The classic presentation of TN (type 1) is characterized by episodes of sudden, explosive severe pain along the trigeminal nerve, with periods of pain-free remission between attacks. The atypical form of TN (type 2) presents with the paroxysmal pain of classic TN, but with the addition of a constant pain that fluctuates from a dull aching to an excruciating roar. Trigeminal neuralgia is considered by medical experts to be one of the most painful conditions known.

Although TN is incurable, its symptoms can be managed with a variety of treatment options, including medication and surgery. The anticonvulsant carbamazepine, and oxcarbazepine, control trigeminal neuralgia so well that a response to the medication can be used to confirm a suspected case of TN. Although carbamazepine is considered the first line treatment for TN, the disorder can be difficult to control. A patient may try a combination of anti-epileptic, anti-anxiety, anti-depressant, and even opioids before finding the treatment regimen that controls the pain. Surgical treatment of TN is only pursued when medications fail to control symptoms.

It is estimated that 1 in 15,000 or 20,000 people have TN, although the actual figure may be significantly higher due to misdiagnosis. TN symptoms usually appear in individuals over 50 years old, but there have been cases in individuals as young as three years old.