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Trigeminal neuralgia
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Trigeminal neuralgia

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Contributors: Carolyn Zyloney MD, Richard L. Barbano MD, PhD
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Synopsis

Trigeminal neuralgia, or tic douloureux, is a chronic neurologic disorder of the fifth cranial nerve (trigeminal nerve) that causes a characteristic facial pain. The pain associated with trigeminal neuralgia is typically sharp, brief (lasting seconds to a minute), unilateral, and in the distribution of one or more branches of the trigeminal nerve. However, some patients may have concomitant continuous pain in the territory of the trigeminal nerve, which is termed type 2 trigeminal neuralgia. Sensory and motor deficits are absent. There is often a location on the face that triggers the pain, so activities such as shaving, teeth brushing, or face washing may bring on a painful episode. Attacks occur for periods of time, often followed by spontaneous remission. The pain, however, will typically return within months to years.

The annual incidence of trigeminal neuralgia is about 5 people per 100 000. It can occur at any age but is more common in people over age 50. It is about twice as common in women compared with men.

Trigeminal neuralgia is most commonly due to neurovascular compression of the trigeminal nerve root. It may also occur secondary to injury of the fifth cranial nerve from trauma, demyelinating disease, vascular injury, or compression by a tumor or other mass lesion. About 15% of patients evaluated for trigeminal neuralgia are found to have a secondary cause based on imaging. It can also be idiopathic without any clear associated structural abnormality on neuroimaging.

Carbamazepine is the most common treatment for trigeminal neuralgia and is effective in more than half of patients. There are several other medications and interventional treatments available for refractory cases.

Codes

ICD10CM:
G50.0 – Trigeminal neuralgia

SNOMEDCT:
31681005 – Trigeminal neuralgia

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Last Reviewed: 06/21/2018
Last Updated: 06/21/2018
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Trigeminal neuralgia
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Trigeminal neuralgia : Headache, Jaw pain, Mouth pain, Muscle spasm, Recurring episodes or relapses, Unilateral, Neuralgia
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