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Tic Douloureux

Tic Douloureux Treatment

Self-Care at Home

There are no effective home treatment remedies for tic douloureux. Treatment should be guided by a physician. The role of the doctor is to ensure the diagnosis, begin appropriate therapy, and coordinate any potential need for consultants. In most cases, effective treatment will require only medications. Uncommonly, surgery will be recommended.

Medical Treatment

The primary treatment of tic douloureux is medication to control the pain. Surgery may be necessary when drug therapy is not effective or side effects from the medications are not tolerable.

Medications

A number of medications are effective in helping control the pain of tic douloureux. The most commonly prescribed medications are anticonvulsants (seizure medications). Anticonvulsants help to stop the irritated trigeminal nerve from firing pain impulses.

  • The most frequently prescribed anticonvulsant medication for tic douloureux is carbamazepine (Tegretol). Oxcarbazepine (Trileptal) and lamotrigine (Lamictal) may also be effective, These medications are generally started at a low dose and then increased until pain is controlled or side effects occur. Common side effects include drowsiness, dizziness, double vision, and nausea. Rarely, serious liver or bone marrow problems can occur.
  • [Baclofen (Lioresal), a muscle relaxant, may be useful for some people who either do not respond to anticonvulsants or who suffer serious side effects.
  • An antipsychotic medicine pimozide (Orap) has been helpful in some cases as well.
  • Opioid pain medications can be useful during episodes of severe pain.

Medication is at least partly effective for 80% -to 90% of the people who suffer with tic douloureux. For the rest, drug therapy either fails to provide adequate pain control or adverse side effects are intolerable. Unfortunately, many people who initially respond to anticonvulsants eventually develop resistance to the medications.

Surgery

When pain cannot be controlled with medication, surgical options should be discussed with a neurosurgeon. Surgery could range from simple injections of anesthetic into the trigeminal nerve to complex procedures that must be performed in the operating room. In general, the more complex procedures provide longer-lasting pain relief but with greater potential for more serious complications.

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