Facial pain is often blamed on TMD - a complex disorder in the jaw joint (the temporomandibular joint). But if you experience fleeting episodes of intense, stabbing, electric shock-like pain around your lips, eyes, nose, scalp, forehead, or upper or lower jaw, you may have a condition called trigeminal neuralgia (also called TN or ticdouloureux).

TN sufferers describe the episodes as jolts of excruciating, agonizing pain, triggered by such simple acts as chewing, brushing teeth, or even a light breeze brushing against the cheek. Although the attacks are short-lived, they make up in intensity what they lack in duration. The disorder typically affects only one side of the face, but some people experience pain at different times on both sides. The onset of TN symptoms usually occurs after age 50, but they can affect children and even infants.

TN attacks tend to run in cycles. It's common for patients to go through periods of frequent attacks, followed by weeks, months, or even years with little or no pain. However, TN rarely goes away on its own, and the pain associated with the disorder tends to worsen over time, with fewer and shorter pain-free periods. While not fatal, TN pain is highly disruptive to your life, and it can become almost incapacitating.

The specific cause of trigeminal neuralgia has not been determined; compression of the trigeminal nerve by a vein or artery, physical injury, or rarely, tumors or multiple sclerosis, can all cause nerve damage resulting in facial neuralgia pain.

* Initially, the treatment for TN includes oral anti-convulsant drugs such as Neurontin, Tegretol or Lioresal to control the attacks.

* Anti-depressant drugs may also have a significant pain-relieving affect.

* A Gamma Knife, a source of highly focused, intense radiation, has been successfully used to treat TN pain. The rays treat the nerve

* Neurosurgical procedures are also available to relieve pressure on the nerve and reduce its sensitivity.

* Alternative therapies such as chiropractic adjustment, acupuncture, self-hypnosis, and meditation have reduced painful TN symptoms in some patients.