A brief guide to understanding trigeminal neuralgia

Suddenly, someone has jabbed a pencil in your face or poked it with an electric probe -- at least that's how you feel. If this happens, you may be suffering from trigeminal neuralgia, or tic douloureux.

It's an intense pain caused by the irritation of the trigeminal nerve that has three branches on each side of the face.

• Trigeminal neuralgia usually strikes only one side of the face, often along the jaw. It begins with short, mild attacks, but those can become longer and more intense, triggered by nothing you can point to — or by something as simple as touching your face or brushing your teeth.
• You may have several attacks a day for weeks or months and then a period of time when you have no pain at all. A less common form of trigeminal neuralgia causes a continuous burning sensation that is harder to treat.

The syndrome is usually caused by contact between the nerve and a major artery or vein at your brain's base.

• This puts pressure on the nerve, causing it to misfire. People over age 50, especially women, are most at risk.
• High blood pressure, multiple sclerosis, or a tumour pressing on the nerve can also trigger the syndrome.
• There may also be a genetic component, or it may be the result of an accident involving the face.

If your face is burning or you feel jolts of pain that make lightning seem tame, see your doctor.

• Your doctor will examine you, asking you to describe your symptoms. He will also give you a neurological exam to rule out other disorders such as postherpetic neuralgia, a complication of shingles, or cluster headaches.
• He may also use MRI to rule out multiple sclerosis or tumours. Once he confirms that you have trigeminal neuralgia, he may prescribe several treatments.
• Fortunately, there are medications and self-care measures that can help diminish the pain. If noninvasive measures don't help, your doctor may recommend one of several types of surgery.

If you have these symptoms that are not explained by another known condition, see your doctor about the possibility of having trigeminal neuralgia. While it is a serious and painful condition, there is a lot of help available once you are diagnosed.