Trigeminal Neuralgia (Tic douloureux)

Intense paroxysmal neuralgia along the trigeminal nerve.

Etiology:

Blood vessel compression of the trigeminal nerve root as it enters the brain stem.  Normally blood vessels are not in contact with the trigeminal nerve root zone.

This neurovascular or microvascular compression at the trigeminal nerve root entry zone may be caused by arteries of veins, large or small, that may simply contact or indent the trigeminal nerve .

The superior cerebellar artery is the vessel most often responsible for neurovascular compression upon the trigeminal nerve root, although other arteries or veins may be the culprit vessels.

Additional causes may be due to:

  1. Tumor pressing on the nerve root
  2. Neurologic degeneration such as in neurodegenerative disease
  3. Craniofacial trauma to the area

 

Manifestation:

A chronic pain condition that causes extreme, sporadic, sudden burning or shock-like face pain.

Treatment and Management:

  1. Avoidance or limitation of behaviors or actions with may stimulate the trigeminal nerve root resulting in pain such as physical trauma to the area.
  2. Surgical intervention to relieve  neuromuscular compression upon the trigeminal nerve root, called microvascular decompression.

Kaufmann, A, M and Patel, M. 2001. Your Complete Guide to Trigeminal  Neuralgia. Center for Cranial Nerve Disorders, Winnipeg, Canada. Retrieved July 7 2010 from http://www.umanitoba.ca/cranial_nerves/trigeminal_neuralgia/manuscript/types.html.

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