Treatment typically involves sedating the patient and the nervous system to keep it as quiet and free from stress as possible. One of its most severe forms is trigeminal neuralgia, also called tic douloureux, a condition stemming from problems with the trigeminal or fifth cranial nerve. One of the largest nerves in the head, the trigeminal nerve sends impulses of touch, pain, pressure, heat and cold to the brain from the face, jaw, gums, forehead and the region around the eyes. The condition is characterized by a severe, jolting, electric shock-like or stabbing pain on one side of the jaw or cheek. An attack typically lasts only a few seconds, but may recur again and again throughout the day, sometimes being triggered by talking, brushing the teeth, touching the face, chewing or swallowing.
Some attacks persist for days, others for months, before disappearing for months or years.
Several drugs are used to treat trigeminal neuralgia, including medications such as carbamazepine, caclofen, clonazepam and valproic acid, along with tricyclic antidepressants. Where medication is ineffective, trigeminal neuralgia sufferers may seek thermocoagulation treatment to destroy the nerves to the face with heat. Fortunately, the nerves that conduct facial pain are most sensitive to this treatment, and can be isolated for destruction without compromising other facial sensations. In some cases, doctors find that blood vessels in the brain may lie too closely to a group of nerve cells connecting sensory fibers to the face, exerting pressure that causes pain. Surgically inserting a small sponge between the blood vessels and the nerve cells sometimes relieve this pain.