What is Tic Douloureux? Symptoms, Diagnosis and Treatment

Trigeminal neuralgia, also known as tic douloureux, is a chronic pain condition.

  • Symptoms include stabbing, electric pain in response to everyday activities like chewing.
  • A specialist diagnoses it based on symptoms. There are no tests for tic douloureux.
  • Treatment options include medication, surgery and Gamma Knife radiosurgery.

Understanding Your Trigeminal Neuralgia

Trigeminal neuralgia/tic douloureux is a chronic pain condition that affects the face. This pain can be so severe that it’s often referred to as the “suicide disease.” The good news is that doctors have come to understand the condition better, and there are trigeminal neuralgia specialists in the NJ area who can provide treatment to help give you relief from your pain.

Learning more about your tic douloureux is a powerful way to set your mind at ease, wherever you are in the process. To help you discuss tic douloureux with your doctor after your diagnosis, let’s review the symptoms, diagnosis process and treatment options available to patients in the tri-state area.

What is Tic Douloureux: Symptoms and Causes

Pain is the one symptom most often associated with tic douloureux/trigeminal neuralgia. However, there are some characteristics of the pain associated with tic douloureux that are unique. Doctors now understand more about the underlying cause of tic douloureux, and a brief explanation may help you understand your symptoms.

Though rare cases of trigeminal neuralgia do not have an apparent underlying cause, doctors have learned that the most frequent etiology is a blood vessel near the brain pressing on the trigeminal nerve. This nerve transmits information about touch from the face to the brain, including pain. Sometimes another structure, such as a tumor, could be the culprit, but the common factor is something impinges on the trigeminal nerve, resulting in it firing inappropriately.

Think of the trigeminal nerve as being hyperactive due to the impingement, transmitting pain signals to the brain when it should not be. Characteristic symptoms resulting from an impingement include:

  • Episodes of pain that can be described as “electrical” and “stabbing,” lasting seconds to minutes and increasing with time
  • Pain in response to non-painful activities, such as speaking, eating and brushing your teeth
  • Pain on one side of the face, which can be debilitating

What is Trigeminal Neuralgia: Diagnosis

Unfortunately, there is no test available to screen for tic douloureux/trigeminal neuralgia. Instead, your doctor will form a diagnosis based on the symptoms you are experiencing and by ruling out other conditions. This is why it is vital to find a trigeminal neuralgia specialist in northern NJ who has experience diagnosing and treating tic douloureux. They will work with you to discuss your specific symptoms to confirm your diagnosis. Diagnostic imaging can also be helpful to determine the underlying cause, such as a blood vessel or tumor.

What is Trigeminal Neuralgia: Treatment Options

Your doctor will develop a treatment plan based on your condition and the cause of your tic douloureux, considering the underlying cause and your health factors. Potential trigeminal neuralgia treatment options include medication, surgery and Gamma Knife radiosurgery.


Your doctor may recommend medication to help relieve your tic douloureux pain and prevent the onset of attacks. Classes of drugs include tricyclic antidepressants, muscle relaxers and anti-seizure medications. These medications may help provide relief until you can undergo other treatment or if you cannot undergo surgery. However, the drugs may lose effectiveness over time.


If a tumor is causing your tic douloureux, a neurosurgeon may be able to remove it to resolve your symptoms. However, the more common cause is the impingement of a small blood vessel in the brain, which doctors can treat using microvascular decompression. During this treatment, the neurosurgeon can remove or relocate the offending blood vessel to remove the impingement and restore proper function to the trigeminal nerve.

Gamma Knife Radiosurgery

Gamma Knife radiosurgery is an advanced form of radiation therapy that treat an aberrant blood vessel just like surgery but without incisions or scalpels. It can be an excellent treatment option for patients who are not surgical candidates or who prefer a minimally invasive approach. Gamma Knife radiosurgery is available to patients in northern NJ and does not require a hospital stay, has a short recovery period and is an effective way to treat tic douloureux.

Work with a Trigeminal Neuralgia Specialist

As you move forward through your tic douloureux/trigeminal neuralgia diagnosis and treatment, it is crucial that you work with a doctor who has experience in treating your condition. They will be able to recognize your symptoms, work with you to find the underlying cause and ultimately recommend a treatment plan based on your case.

Tic douloureux used to be a complex condition to understand and treat. However, doctors and researchers have learned what can cause the trigeminal nerve to become overactive, leading to the pain you have been experiencing. Thankfully, patients in NJ and around the world now have treatment options available to provide relief.

Anthony D’Ambrosio, M.D., M.B.A., F.A.A.N.S
Anthony D’Ambrosio, M.D., M.B.A., F.A.A.N.S
Dr. Anthony D’Ambrosio is a board-certified neurosurgeon that specializes in Neurosurgery, Stereotactic Radiosurgery, Gamma Knife Radiosurgery (GKRS) and more. He is the Director of Neurosurgery and Co-Director of the Gamma Knife Program at The Valley Hospital. Dr. D’Ambrosio is an expert in treating patients with trigeminal neuralgia, benign or malignant brain tumors, as well as many other neurological conditions.

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