Understanding and Managing Trigeminal Neuralgia: Expert Unmasks the Suicide Disease

Trigeminal Neuralgia (TN), colloquially known as “tic douloureux” or the “Suicide Disease,” is a debilitating chronic pain condition that afflicts the trigeminal nerve, causing recurrent, intense electric shock-like pains in the facial regions it supplies.

We spoke to our expert Dr (Col) Joy Dev Mukherji, Vice Chairman & Head- Neurology, Neurosciences, Max Super Speciality Hospital, Saket, as he sheds light on the causes, risk factors, diagnosis, and various management options for individuals grappling with this challenging condition.

Causes of the Suicide Disease

The primary cause of TN is often the compression of the trigeminal nerve root near its entry into the pons. This compression, typically by an adjacent artery or vein, accounts for 80-90% of TN cases.

Additionally, other factors contributing to nerve compression include meningioma, acoustic neuroma, epidermoid cyst, arteriovenous malformation, and rarely, saccular aneurysm. Multiple sclerosis, leading to demyelination of the trigeminal nerve nucleus, is a recognised risk factor, reported in 2-4% of TN patients.

Diagnosis of the Suicide Disease

While Trigeminal Neuralgia is primarily a clinical diagnosis, it is crucial to conduct an MRI of the brain with and without contrast to rule out structural brain lesions in all suspected cases. Patients under 40 years of age, those with bilateral symptoms, and those exhibiting sensory loss on examination are at higher risk of secondary trigeminal neuralgia.