Trigeminal neuralgia

The International Headache Society (IHS) defines trigeminal neuralgia as “a unilateral disorder characterised by brief electric shock-like pains, abrupt in onset and termination, limited to the distribution of one or more divisions of the trigeminal nerve”.

• often described by patients as the "the world's worst pain." (2)
• french term "tic doloreux" describes the suddenness of the pain that may be triggered by touch or cold (3)

It is rare condition with an incidence of 27 per 100 000 person years in the United Kingdom

• prevalence increases with age with a peak incidence between age 50 and 60 years
• women are more at risk than men

IHS divides trigeminal neuralgia into two distinct categories:

• classical - no identifiable cause can be found other than a vascular compression of the trigeminal nerve
• symptomatic - a cause can be identified, other than a vascular compression, such as a tumour, arteriovenous malformation or multiple sclerosis (MS) (1)

Reference:

• (1) The International Headache Classification (ICHD-2). The Classifiation. Part three: Cranial neuralgias, central and primary facial pain and other headaches
• (2) Luke Bennetto, Nikunj K Patel, and Geraint Fuller.Trigeminal neuralgia and its management.BMJ 2007; 334: 201 - 205
• (3) Editorial. Treatment options for trigeminal neuralgia. BMJ  2003;327:1360-1361