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Orofacial Pain and Temporomandibular Disorders


Trigeminal Neuralgia

What is it?

Trigeminal neuralgia (TgN) or tic douloureux is pain disorder involving the firth cranial nerve (Trigeminal nerve).


Signs or Symptoms

Typical TgN causes sharp sudden shock like pains along the fifth cranial nerve.

  • Severe intense pain

  • Lasting seconds to minutes at most

  • An atypical form also exists with lower intensity and longer lasting pain.

  • Triggered by certain activities for example shaving, brushing teeth and washing one’s face

  • The pain usually eases at night-time and rarely wakes a person from their sleep.


TgN can be caused by damage to the protective coating (myelin sheath) around the 5th cranial nerve. This damage can be due to pressure from a blood vessel or from another intracranial cause -tumour for example. On occasion TgN is an early sign of multiple sclerosis.

Idiopathic trigeminal neuralgia is the name given to TgN for which no identifiable cause can be found.


A detailed medical and family history as well as history of the pain often indicated a diagnosis of TgN. A clinically examination including cranial nerve examination as well as imaging of the brain (MRI) is then required to diagnose TgN.



Treatment for idiopathic trigeminal neuralgia is often medication (anti-convulsant medication), other treatment modalities include Botox injections and neurosurgery. At Perth Oral Medicine and Dental Sleep Centre we carry out medicinal and injectable therapies for TgN as well as working closely with neurosurgeons to get the best patient outcomes.


Most patients recover from TgN with appropriate and swift treatment. Some may require low dose long term medication to prevent reoccurrence. If you have had TgN in the past you are more likely to have a reoccurrence, these reoccurrences however can be swiftly dealt with when and if they do occur.

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