Trigeminal neuralgia

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Trigeminal neuralgia, also called tic fouloureux, is a neurologic pain syndrome characterized by recurrent episodes of excruciating pain lasting several seconds or longer in the sensory distribution of the trigeminal nerve. Pain may be initiated by stimulation of trigger points on the face, lips, or gums or by movement of facial muscles or chewing. The pain has been described as one of the worst known, and the suicide rate for untreated patients was high.

It has been associated with multiple sclerosis, vascular anomalies, aneurysms, and neoplasms. [1]

The first direct relief came with surgical or chemical destruction of the trigeminal nerve, leaving motor and sensory deficits. A major breakthrough came when it was discovered that anticonvulsants, originally carbemazepine, could desensitize the nerve and reduce or stop the pain. There are also some surgical techniques to free the nerve from pressure.

  1. Adams et al., Principles of Neurology, 6th ed, p187, in Medical Subject Headings