Tic Douloureux Symptoms continued...
The pain comes in intermittent episodes that last from a few seconds to a few minutes. There may be many episodes of pain each day. There is usually no pain between episodes.
The flurry of pain episodes may last from a few weeks to a few months, followed by pain-free periods of months to even years. Generally, the episodes become more frequent and more resistant to treatment with medications over time.
The attacks of pain are often initiated by physical stimulation of a trigger point on the same side of the face as the pain. Trigger points can be anywhere on the face or in the mouth or nose. They are generally not in the same place as the pain. Stimuli that can initiate the pain include talking, eating, brushing the teeth, or even cool air on the face. There is no loss of taste, hearing, or sensation in someone suffering from tic douloureux.
When to Seek Medical Care
Call your doctor when the prescribed medications are not controlling the pain, or if you develop new symptoms. Because tic douloureux is a pain-only syndrome, the development of new symptoms may warrant additional evaluation.
Go to a hospital's emergency department if you experience symptoms such as fever, redness of your face, or dizziness. These symptoms may not be related to your condition and may signify another illness. If your prescribed medication is not relieving the pain and your doctor is not available for advice, go to the hospital.
Exams and Tests
There is no single medical test to diagnose tic douloureux. The diagnosis is made based on the description of the pain, physical examination, and exclusion of other causes of facial pain.
The pain is unique. A history of bursts of shooting pain in one side of the face along with a trigger zone will give the doctor good clues to the cause of your pain.
The physical examination is normal in tic douloureux. If numbness, decreased hearing, dizziness, visual changes, or dysfunction of the muscles of the face is found, then other disorders may be considered. Additionally, other causes of facial pain such as a sinus infection, dental infection, or a jaw disorder, such as TMJ, can often be found by physical examination.
Special X-ray images, such as a CT scan or MRI of the head, can look for other causes of facial pain. They can also help delineate blood vessels or tumors that might be pressing on the nerve and irritating it.