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Trigeminal Neuralgia

Trigeminal neuralgia (TNA) involves a sudden and severe burst of pain in the face, head and jaw. This disorder is also known as tic douloureux. The pain is actually following the trigeminal nerve, and is usually on just one side of the face. Patients often describe the pain as being like an electric shock. Both men and women can suffer, but those who most commonly suffer are women over 50.

An attack can come because of pressure to the face, even something simple like brushing your teeth or chewing. The pain is often started when a certain "trigger zone" is activated. The pain is very unpredictable, and can start for no apparent reason. It may come suddenly and then disappear for days, months or years.

The pain itself may last for a few seconds or a few minutes. Then there is something called the refractory period when a new attack cannot be triggered.

The cause is not fully understood, but it may be related to a loss of the protective layer over the trigeminal nerve (the myelin sheath). Some conditions and diseases such as multiple sclerosis actually cause this.

Treatment includes anticonvulsant medications such as carbemazepine (Tegretol). When medication doesn't solve the problem, there are also surgical methods that have been successful.

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References: Stedman's Medical Dictionary; Migraine and Other Headaches by Drs William B Young and Stephen D Silberstein; National Institute of Neurological Disorders and Stroke article "NINDS Trigeminal Neuralgia Information Page" from 9 Feb 2005;