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Tic Douloureux (Trigeminal Neuralgia) Facts

After 22 years as an RN, I now write about medical issues and new medical advances. Diet, exercise, treatment, and lifestyle are important.

Edvard Munch's "The Scream" has been used as a symbol of facial pain generally, and also specifically of trigeminal neuralgia.

Edvard Munch's "The Scream" has been used as a symbol of facial pain generally, and also specifically of trigeminal neuralgia.

Trigeminal Neuralgia Facts

Trigeminal neuralgia (TN) is also known as tic douloureux, a chronic disorder. This is a very painful long-term disorder.

This disorder affects the trigeminal nerve, which is the longest and most complex of the twelve cranial nerves in your head. There is a trigeminal nerve on each side of the face, and it is responsible for detecting touch, pain, temperature, and pressure sensations in areas of the face between the forehead and the jaw. It is the primary nerve for the muscles for mastication.

This condition tends to affect people over the age of fifty, but it can occur at any age. Young adults with multiple sclerosis are at an increased risk due to deterioration of the myelin sheath. It is more common in women than in men. This disorder occurs in approximately twelve in one hundred thousand people, so it is somewhat rare.

Causes of Trigeminal Neuralgia

The exact cause of this disease is not well understood. The bulk of the cases result from a blood vessel pressing against the trigeminal nerve, and this compression does damage. Some research indicates that an injury to the nerve results in loss of or damage to the myelin sheath that surrounds the nerve. The myelin sheath is a fatty covering of the nerve cells. This may result in increased electrical activity in the nerve, triggering the pain regions of the brain.

A tumor may be pressing on the nerve in rare cases. Quite often the cause is unknown, making it an idiopathic disease. Another rare cause can be a tangle of arteries and veins called an arteriovenous malformation. Injury to the trigeminal nerve may be the result of sinus surgery, oral surgery, stroke, or facial trauma.

TN Types

The two main types of TN are typical of Classical (TN1) and atypical (TN2) trigeminal neuralgia. TN is often associated with a variety of conditions. At first, you may experience short, mild attacks. This disease can progress, causing longer, more-frequent bouts of searing pain.

The typical type of trigeminal neuralgia results in very intense, stabbing, and sudden, shock-like pain that occurs on one side of the face and may last from seconds to several minutes. The atypical neuralgia results in less intense but constant burning or dull aching pain that is typically over a larger area of the face.


The symptoms of TN include one or more of the following patterns, that include:

  • Severe, shooting or jabbing pain on the face that feels like an eclectic shock
  • Triggered or spontaneous attacks triggered by a touch on the face, chewing, speaking or brushing teeth
  • Facial pain that lasts from a few seconds to several minutes
  • Pain felt in one spot or spread in a larger area
  • Episodes of numerous attacks that last for days, weeks, months, or longer
  • Pain on one side of the face, but rarely affecting both sides
  • Constant aching, burning pain that may occur before it evolves into a spasm-like pain
  • Pain in the areas that are supplied by the trigeminal nerve (cheek, lips, jaw, teeth, gums, or less often in the eye or the forehead)
  • Painful attacks that increase in frequency or intensity over time
Does one side of your face hurt?

Does one side of your face hurt?

TN Diagnoses

Trigeminal neuralgia is suspected when a person has pain affecting only one side of their face. While there are no specific criteria for a diagnosis, trigeminal neuralgia is typically diagnosed using several factors, including:

  • Detailed patient history
  • Identification of characteristic symptoms
  • Clinical evaluation
  • High-Resolution MRI to assess for or rule out underlying causes

People with trigeminal neuralgia may experience a jolt of excruciating pain when they brush their teeth, hair, or put on makeup.


The treatment will depend on the probable cause and numerous factors. The patient does not have to live a life of pain as there are injections, medications, or surgery that will treat this painful disease.

Anti-seizure medications (anticonvulsants), carbamazepine, or oxcarbazepine are common treatments. Drugs tend to be effective in the early stages of this disease. Medications are begun in low doses with increases until the pain subsides. The benefits of these medications tend to lessen over time. Muscle relaxants, such as baclofen, may be used in addition to the anti-seizure medication. Tricyclic antidepressant medications such as amitriptyline and nortriptyline may also be prescribed. Opioids are typically not effective.

When the first two medications are not effective, surgery will be considered. A common surgery is a microvascular decompression, known as the Janetta procedure. This procedure moves the blood vessel that is compressing the nerve. Other surgical procedures interrupt the transmission of pain signals to the brain or if there is a tumor, it will be removed.

Now You Know!

There are medical research studies in progress to look for the actual cause of this disease and better ways to treat the disease. The trigeminal nerve is a large nerve, so when it is compressed in some way the pain is excruciating. Anyone experiencing facial pain on one side of their face should be evaluated by a physician as soon as possible.


This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2021 Pamela Oglesby


Pamela Oglesby (author) from Sunny Florida on January 07, 2021:

Hi Flourish,

I'm glad to hear you were treated successfully. I remember how much pain the woman had that I knew, and she was treated more than once. I appreciate your comments. Stay heathy, Flourish!

Pamela Oglesby (author) from Sunny Florida on January 07, 2021:

Hi Adrienne,

It is an awful disease. The "Scream" picture has been used before for this disease. It is rare, thank goodness. Thank you so much for your comments.

FlourishAnyway from USA on January 07, 2021:

When I first was diagnosed with MS I had an awful case of trigeminal neuralgia on the left side of my face (shooting electrical pains in the jaw). However, with the help of medicine, it subsided and has not returned.

Adrienne Farricelli on January 07, 2021:

Your picture of the "Scream" by Edvard Munch is very effective to depict such a painful condition. I hope to never suffer from trigeminal neuralgia, it sounds like a terrible condition.

Pamela Oglesby (author) from Sunny Florida on January 07, 2021:

Hi Linda,

This is very painful and I think any disease that involves nerve damage is always more painful. I appreciate you comments. Stay safe and healthy!

Linda Crampton from British Columbia, Canada on January 06, 2021:

This sounds like a very unpleasant disorder. I’m glad to hear that some treatments are available. I hope researchers soon find new and even better ones.

Pamela Oglesby (author) from Sunny Florida on January 06, 2021:

Hi Doris,

I use to have migraines but they have slowly disappeared. Old age?? I really don't know why, but I would not like a seafood allergy. Lobster bisque is such a pleasure but not worth a migraine.

Thanks for reading and commenting, Doris. I hope 2021 is a better year for you and all of us.

Doris James MizBejabbers from Beautiful South on January 05, 2021:

Very interesting. At first I thought it was the nerve that I used to call my "migraine nerve", but it wasn't. At least I got rid of my migraines, well most of them. I discovered that my migraines caused by a seafood allergy had returned. Sob, no more lobster bisque. Keep up the good work, Pamela.

Pamela Oglesby (author) from Sunny Florida on January 05, 2021:

Hi Devika,

I am glad this article provided some new information for you. Thank you so much for your nice comments.

Devika Primić from Dubrovnik, Croatia on January 05, 2021:

Pamela99 Your work is incredible! Such information is often ignored. It is important to know of this nerve disorder and in detail allowed me to learn more from the topic.

Pamela Oglesby (author) from Sunny Florida on January 05, 2021:

Hi MG,

It is a terrible disease. Any disease that causes damage to a nerve is extremely painful. I don't want anyone to suffer like this and I am glad most cases can be treated successfully.

Thanks for reading and commenting.

MG Singh emge from Singapore on January 04, 2021:

You have written a fascinating article about a subject I have heard about for the first time. Looks like this disease is terrible and I hope nobody gets it.

Pamela Oglesby (author) from Sunny Florida on January 04, 2021:

Hi Osman,

I am glad you find my articles informative. Thank you for commenting.

Pamela Oglesby (author) from Sunny Florida on January 04, 2021:

Hi Manatita,

Your articles arou have been blesse splendid, so I think you have been blessed with a great deal of talent.

I appreciat your comments. Have a wonderful week.

Osman Ghazi on January 04, 2021:

Really I feel good to read your informative articles.

manatita44 from london on January 04, 2021:

Excellently explained. God has not granted me this blessing, I don't think. Hopefully, I don't need it. Sounds painful. Peace.

Pamela Oglesby (author) from Sunny Florida on January 04, 2021:

Hi Ruby,

It is a rare disease, thank goodness. Thank you for your comments. Have a wonderful week!

Pamela Oglesby (author) from Sunny Florida on January 04, 2021:

Hi Peggy,

I knew somone quite a long time ago that had this problem, and she was in so much pain. I imagine the treatments have improved now.

I appreciats your comments, Peggy, Have a good week!

Ruby Jean Richert from Southern Illinois on January 04, 2021:

Wow, this would be a terrible disease to have. I haven't seen or known anyone who had it. Excellent article indeed!

Peggy Woods from Houston, Texas on January 04, 2021:

I have never known anyone who has suffered from this disorder. It sounds terrible! At least there are some remedies to help alleviate the pain. Thanks for keeping us informed, Pamela.

Pamela Oglesby (author) from Sunny Florida on January 04, 2021:

Hi Mel,

It sounds like you may have sciatica, which originates from a nerve in your back. A pain doctor or some physical therpy might help. It could be something else I guess, but it sounds like a nerve pain. It is not the same cause as trigeminal neuralgia, as sciatica is usually to do with a narrowing of the spinal bones.

I appreciate your comments, Mel. I hope you have a good week to start off the new year.

Mel Carriere from Snowbound and down in Northern Colorado on January 04, 2021:

Great stuff. Can this type of neuralgia occur in other areas of the body? Right now I have a mystery pain in my lower right leg. When I lean up against the side of my Postal vehicle, I get sort of the electric shock you are speaking of. I see no evidence of bruising or cuts down there. The pain feels like it comes from a tender nerve. Any ideas?

Pamela Oglesby (author) from Sunny Florida on January 04, 2021:

Hi Linda,

I haven't been called amazing very often in this lifetime, so thank you. That is exactly what I try to do.

This is a dreadful disease. I am glad you find the article interesting, and I always appreciate your comments. Have a great week, Linda!

Linda Lum from Washington State, USA on January 04, 2021:

Pamela, I had not heard of this but it sounds absolutely dreadful. Thank you for the education. I'm always impressed that you can take all of this medical terminology and translate it so that we can understand. You're amazing!

Pamela Oglesby (author) from Sunny Florida on January 04, 2021:

Hi Bill,

I knew a woman who had this disease a few years agoa, and when I happen to see that picture (Scream) I decided to write about it.

I am glad you appreciate all your new knowledge of various illnesses, and you comments are always appreciated, my friend. Have an excellent week.

Bill Holland from Olympia, WA on January 04, 2021:

I can't pronounce it, but I sure do think it sounds painful from your description. As always, I appreciate the education. I have heard of this, but had no clue what it was. Thank you Pamela! Have a great week.

Pamela Oglesby (author) from Sunny Florida on January 04, 2021:

Hi Chitrangada,

This disease is more painfulk than a headache but thank goodnss it is rare.

Tinnitus was no cure. I think it is to do with tiny hairs in the ear, but I would have to do some research to tell you more. I have tinnitus, and the doctor told me there is nothing they can do.

I appreciate your very nice comments.

Pamela Oglesby (author) from Sunny Florida on January 04, 2021:

Hi Ankita,

Thia is a rare disease, but an awful one due to the pain. Thank you for your comments. Have a good week.

Pamela Oglesby (author) from Sunny Florida on January 04, 2021:

Hi Rosina,

This is rare, but I knew a lady that had it. I am glad you found this article helpful.

I appreciate your comments.

Chitrangada Sharan from New Delhi, India on January 04, 2021:

Excellent and informative article about this painful chronic pain.

I had no idea about this disorder, till I read your aticle. We, usually can't distinguish between painful conditions, especially headaches. Good of you to share this valuable information with the readers.

I was curious about a disease, which has symptoms, more or less like Tinnitus. Can you share some information about Tinnitus?

Thank you so much for sharing this well written and researched article.

Ankita B on January 04, 2021:

Very interesting article on this somewhat rare disease. Greatly informative. Thank you for sharing.

Rosina S Khan on January 04, 2021:

This nerve disorder was unknown to me. Glad this article educated me about it. Thank you, Pamela for the helpful and superb share.