Tic douloureux

Pain in the face can be caused by various factors. Known syndromes include hemicrania, or migraine, and trigeminal neuralgia. Hemicrania occurs above all in men and is characterized by regular attacks of disabling throbbing pain around one eye, possibly radiating to the temple and jaw; there are also local disturbances such as streaming eyes, running nose, narrowing of the pupils and drooping eyelid. The attacks occur several times per day for several weeks or months, followed by a long period without attack. The cause is not entirely clear. Trigeminal neuralgia is also associated with recurrent shooting pain lasting for several seconds in the cheek or jaw, caused by touching a ‘trigger spot such as a nostril or the corner of the mouth. In this condition too there are periods, sometimes lasting for years, which are free of attack. In the case of facial pain other possible causes have to be considered. Pain can also be caused by dental problems, sinusitis, eye conditions (such as glaucoma) or facial shingles. Hemicrania is treated in a similar way to migraine. In trigeminal neuralgia anti-epileptic remedies are the most effective, and it can be eased by surgery to make more space for the trigeminal nerve where it runs through the skull to the brain.