Tic douloureux, or trigeminal neuralgia, causes chronic pain due to pressure on the trigeminal nerve in the head. Pain can be triggered by everyday activities and can be treated with medication or surgery. The upper, middle, and lower branches of the trigeminal nerve provide sensation to different areas of the face. Surgery options include balloon compression, glycerol injection, and microvascular decompression.
Tic douloureux, also known as trigeminal neuralgia, causes chronic pain due to pressure placed on the trigeminal nerve in the head. The primary symptom of the condition is pain, which can be triggered by common actions like eating and drinking. Treatment options for tic pain include medications and surgery.
The trigeminal nerve begins at the base of the brain and extends to different areas of the face. There are three main branches of the trigeminal nerve, which cover the lower, middle and upper parts of the face and provide them with the ability to experience sensation. The upper branch affects the scalp, forehead and top of the nose, while the middle branch affects the cheek, sides of the nose, upper jaw and lip, teeth and gums. The lower branch of the nerve affects the lower jaw, lip, teeth and gums. The painful tic can affect one branch of the trigeminal nerve, or it can affect two or three.
Tic douloureux is characterized by its main symptom: pain. Trigeminal neuralgia causes a special type of stabbing pain that can be compared to an electric shock due to its rapidity and severity. The pain is very short-lived, usually a few seconds, but it is common for multiple twinges of pain to occur one after the other, with possible repeated episodes in the same day. The pain can occur every day or every few days for months or years, sometimes interspersed with dormant periods in which no episodes occur.
Trigeminal nerve pain can be triggered by everyday activities such as eating and drinking, brushing your teeth, applying makeup, or talking. Exposure to wind can also trigger pain; in fact, any type of movement or activity that involves touching the cheek, or vibrating the cheek, can trigger pain. It is rare for pain to occur when a patient is sleeping.
The pain is thought to be caused by blood vessels putting pressure on the trigeminal nerve. Over time, this erodes the protective myelin sheath that covers the nerves, causing nerve pain. While this condition is not fatal, it is extremely debilitating and can cause significant emotional distress and physical pain. Many people with the disorder begin to avoid any activity that could trigger pain. This becomes exceptionally difficult because some triggers, such as eating and drinking, cannot be avoided.
Most cases of Tic douloureux can be treated effectively with anticonvulsant medications. These work by preventing neurons from firing in the affected nerves, thus preventing facial pain. Antidepressants are usually prescribed for the constant or aching pain that some people experience.
Tic pain surgery is recommended for people who cannot find relief with medication. There are several options for surgery, including balloon compression, which prevents pain by causing a small amount of damage to the affected nerves. Another option is called a glycerol injection and involves injecting a small amount of the substance into the area around the affected nerves. Glycerol likewise damages nerves such that pain is no longer felt. A more invasive procedure called microvascular decompression is usually the most effective, as it involves physically displacing blood vessels that put pressure on the nerves.
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