Trigeminal neuralgia, also known as tic douloureux, is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain. This condition is characterized by extreme, sporadic, sudden burning or shock-like facial pain that lasts anywhere from a few seconds to as long as two minutes per episode. The pain can be so severe that it's sometimes called the "suicide disease."

Here are key aspects of trigeminal neuralgia:

  1. Symptoms: The pain is typically felt on one side of the face and is often described as an electric shock. It can be triggered by routine activities such as eating, talking, shaving, or brushing teeth. In some people, the pain can occur spontaneously without any apparent trigger.

  2. Causes: Often, trigeminal neuralgia is caused by a blood vessel pressing on the trigeminal nerve as it exits the brain stem. This pressure can damage the protective coating around the nerve (the myelin sheath). In other cases, it can be caused by a disease such as multiple sclerosis, a tumor, or an arteriovenous malformation. However, in some instances, the cause can be unknown.

  3. Types: There are two types of trigeminal neuralgia:
    • Type 1 (TN1): This is characterized by episodes of sudden, severe, sharp pain.

    • Type 2 (TN2): In this type, the pain is constant and burning with less intense episodes of sharp pain.

  4. Diagnosis: It's based primarily on the patient's history and description of symptoms, with additional diagnostic tests such as magnetic resonance imaging (MRI) to rule out other causes of the pain.

  5. Treatment: Treatment options include medications such as anticonvulsants and antispasmodic agents. In some cases, surgery may be recommended to relieve pressure on the nerve or to damage the nerve to reduce pain.

  6. Prognosis: While trigeminal neuralgia is a chronic condition, the prognosis varies. Many individuals gain significant relief from medications, and surgical treatments can be effective in cases where medication is not sufficient.

Living with trigeminal neuralgia can be challenging due to the unpredictable nature of the pain. Management often requires a combination of medication, lifestyle adjustments, and sometimes surgery, along with support from healthcare providers, family, and support groups.