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Trigeminal Neuralgia (Tic Douloureux): The Suicide Pain

Trigeminal Neuralgia (Tic Douloureux) causes a sudden stabbing pain in the face, specifically on one side, in the areas between the forehead and the jaw. It has been around for centuries and the pain experienced during an episode can be considered one of the most severe types of pain a person can experience. Back when effective treatments were not available, it is said that people have taken their own lives because of the pain, earning it the name “suicide pain”. This disorder affects the fifth cranial nerve also known as the trigeminal nerve which is located on both sides of the face. The trigeminal nerve transmits sensations of pain, pressure, temperature, and touch from the sides of the face to the brain. The pain is usually caused by an irritation of these nerves. This condition is quite rare, affecting only a small percentage of the population. It affects women more than men and is more commonly diagnosed in people over the age of 50. It is rare for people below the age of 40 to suffer from this condition; however it is not impossible for younger people to develop this disorder.

Trigeminal Neuralgia (Tic Douloureux) Causes and Symptoms

The irritation of the trigeminal nerve causes the facial pain people with trigeminal neuralgia experience. The exact cause of the irritation is still unknown, but there are several factors that are believed to be triggers of trigeminal nerve irritation.

  • Compression. Inflamed blood vessels can put pressure on the trigeminal nerve and after some time, the nerve’s outer layer erodes, causing irritation and nerve excitability.
  • Tumors. Pressure on the nerves can be caused by brain tumors or abnormalities in the skull.
  • Multiple Sclerosis. Nerve damage caused by MS can affect the trigeminal nerve causing irritation and pain.
  • Trauma and Infections. Head trauma and brain infections can cause irritation of the trigeminal nerves.

The sudden onset of pain caused by the irritation of the trigeminal nerves is quite severe. Patients often describe the pain they experience as a sharp, stabbing pain that resembles the feeling of an electrical shock which more often affects the lower part of the face. Pain episodes are intermittent and can last for as long as several seconds up to a few minutes. People with trigeminal neuralgia (tic douloureux) can experience multiple episodes in a day with no pain in between episodes. These episodes come in clusters that occur for several weeks to several months after which patients can go for months or years without pain before the cycle starts again. After some time, the space between episodes become shorter and the pain becomes more and more resistant to medications. Episodes can be triggered by physically stimulating a point on the face. This trigger point can be found on the same side of the face as where the pain occurs, although the pain is felt in a different area. These trigger points can be activated by normal every day activities such as eating, talking, brushing teeth or even something as mild as cool air touching the face.

Trigeminal Neuralgia (Tic Douloureux) Treatment

Treating the symptoms caused by this painful disorder involves trying to limit or decrease the ability of the nerves to send pain signals to the brain. Doctors often prescribe an anticonvulsant called carbamazepine. There are alternative drugs that can be prescribed if carbamazepine is not effective in treating the pain. These drugs include phentoin, lamotrigine, gabapentin, topiramate, or valporic acid. Baclofen, a muscle relaxant can also be used alone or in conjunction with an anticonvulsant to treat the pain. Side effects are not uncommon in these types of medication, so for people who can’t handle the side effects, rhizolysis, radiation therapy and surgery are other options to consider.

To get proper treatment for this potentially debilitating disorder, one must get an accurate diagnosis from a doctor. If you suspect that you’re pain may be caused by trigeminal neuralgia (Tic Douloureux), consult a headache specialist immediately.

If you’re experiencing any type of headache pain, schedule an appointment with one of our headache specialists or neurosurgeons immediately for proper diagnosis and treatment.