Person with toothache

Toothache? OR Trigeminal Neuralgia? [Updated 2023]

Trigeminal Neuralgia (TN), also known as Tic Douloureux and or the suicide disease, is a chronic pain condition that affects the trigeminal or 5th cranial nerve, one of the most widely distributed nerves in the head.

Trigeminal Neuralgia is often misdiagnosed as dental pain, since pain is frequently triggered when someone chews or talks. However, pain can also occur when someone touches their face, shaves or simply feels the wind.

Symptoms:

  • Rapid onset of short, severe stabs of pain that hit one side of the face and often last from seconds to minutes.
  • Pain is described as sharp, stabbing, electric-like shocks of pain, which always stays on one side of the face.
  • Usual onset is in the 50’s but can be younger or older.
  • Pain rarely awakens patient from sleep.
  • Pain may be in the upper, lower or middle part of the face.
  • The episodes of pain may come and go rapidly, clusters of episodes tend to come and go. The patient may go months or even years without episodes. Or they can occurs so frequently that they never seem to go away.

Treatment:

Trigeminal Neuralgia, can frequently be treated medically, with Tegretol, or other related medications, but commonly becomes refractory and will need surgery. Microvascular Decompression (MVD), is the most effective treatment option.

 

Other Treatment Options:

  • Burning the nerve with a needle- to produce numbness and stop the pain signals
  • Balloon Compression of the nerve
  • Gamma Knife- a type of radio surgery

While these treatments are alternatives to surgery they are much less effective with a much higher rate of recurrence but can be useful in selected cases.