About fothergill disease

What is fothergill disease?

Trigeminal neuralgia, also known as tic douloureux, is a disorder of the fifth cranial nerve (trigeminal nerve) characterized by attacks of intense, stabbing pain affecting the mouth, cheek, nose, and/or other areas on one side of the face. The exact cause of trigeminal neuralgia is not fully understood.

What are the symptoms for fothergill disease?

Trigeminal neuralgia results in Pain occurring in an area of the face supplied by one or more of the three branches of the trigeminal nerve.

Trigeminal neuralgia symptoms may include one or more of these patterns:

  • Episodes of severe, shooting or jabbing Pain that may feel like an electric shock
  • Spontaneous attacks of Pain or attacks triggered by things such as touching the face, chewing, speaking or brushing teeth
  • Attacks of Pain lasting from a few seconds to several minutes
  • Pain that occurs with facial spasms
  • Bouts of multiple attacks lasting days, weeks, months or longer — some people have periods when they experience no pain
  • Pain in areas supplied by the trigeminal nerve, including the cheek, jaw, teeth, gums, lips, or less often the eye and forehead
  • Pain affecting one side of the face at a time
  • Pain focused in one spot or spread in a wider pattern
  • Pain rarely occurring at night while sleeping
  • Attacks that become more frequent and intense over time

What are the causes for fothergill disease?

Trigeminal neuralgia

Trigeminal neuralgia is caused by a disruption in the trigeminal nerve's function.

In trigeminal neuralgia, also called tic douloureux, the trigeminal nerve's function is disrupted. Usually, the problem is contact between a normal blood vessel — in this case, an artery or a vein — and the trigeminal nerve at the base of your brain. This contact puts pressure on the nerve and causes it to malfunction.

While compression by a blood vessel is one of the more common causes of trigeminal neuralgia, there are many other potential causes as well. Some may be related to multiple sclerosis or a similar disorder that damages the myelin sheath protecting certain nerves. Trigeminal neuralgia can also be caused by a tumor compressing the trigeminal nerve.

Some people may experience trigeminal neuralgia due to a brain lesion or other abnormalities. In other cases, surgical injuries, stroke or facial trauma may be responsible for trigeminal neuralgia.


A variety of triggers may set off the pain of trigeminal neuralgia, including:

  • Shaving
  • Touching your face
  • Eating
  • Drinking
  • Brushing your teeth
  • Talking
  • Putting on makeup
  • Breeze lightly blowing over your face
  • Smiling
  • Washing your face

What are the treatments for fothergill disease?

Trigeminal neuralgia treatment usually starts with medications, and some people don't need any additional treatment. However, over time, some people with the condition may stop responding to medications, or they may experience unpleasant side effects. For those people, injections or surgery provide other trigeminal neuralgia treatment options.

If your condition is due to another cause, such as multiple sclerosis, your doctor will treat the underlying condition.


To treat trigeminal neuralgia, your doctor usually will prescribe medications to lessen or block the pain signals sent to your brain.

  • Anticonvulsants. Doctors usually prescribe carbamazepine (Tegretol, Carbatrol, others) for trigeminal neuralgia, and it's been shown to be effective in treating the condition. Other anticonvulsant drugs that may be used to treat trigeminal neuralgia include oxcarbazepine (Trileptal, Oxtellar XR), lamotrigine (Lamictal), valproate and phenytoin (Dilantin, Phenytek, Cerebyx). Other drugs, including clonazepam (Klonopin), topiramate (Qsymia, Topamax, others), pregabalin (Lyrica) and gabapentin (Neurontin, Gralise, Horizant), also may be used.

    If the anticonvulsant you're using begins to lose effectiveness, your doctor may increase the dose or switch to another type. Side effects of anticonvulsants may include dizziness, confusion, drowsiness and nausea. Also, carbamazepine can trigger a serious drug reaction in some people, mainly those of Asian descent, so genetic testing may be recommended before you start carbamazepine.

  • Antispasmodic agents. Muscle-relaxing agents such as baclofen (Gablofen, Lioresal, Ozobax) may be used alone or in combination with carbamazepine. Side effects may include confusion, nausea and drowsiness.
  • Botox injections. Small studies have shown that onabotulinumtoxinA (Botox) injections may reduce pain from trigeminal neuralgia in people who are no longer helped by medications. However, more research needs to be done before this treatment is widely used for this condition.


Surgical options for trigeminal neuralgia include:

  • Microvascular decompression. This procedure involves relocating or removing blood vessels that are in contact with the trigeminal root to stop the nerve from malfunctioning. During microvascular decompression, your doctor makes an incision behind the ear on the side of your pain. Then, through a small hole in your skull, your surgeon moves any arteries that are in contact with the trigeminal nerve away from the nerve, and places a soft cushion between the nerve and the arteries.

    If a vein is compressing the nerve, your surgeon may remove it. Doctors may also cut part of the trigeminal nerve (neurectomy) during this procedure if arteries aren't pressing on the nerve.

    Microvascular decompression can successfully eliminate or reduce pain for many years, but pain can recur by 10 years in three out of 10 people. Microvascular decompression has some risks, including decreased hearing, facial weakness, facial numbness, a stroke or other complications. Most people who have this procedure have no facial numbness afterward.

  • Brain stereotactic radiosurgery (Gamma knife). In this procedure, a surgeon directs a focused dose of radiation to the root of your trigeminal nerve. This procedure uses radiation to damage the trigeminal nerve and reduce or eliminate pain. Relief occurs gradually and may take up to a month.

    Brain stereotactic radiosurgery is successful in eliminating pain for the majority of people. However, like all procedures, there is a risk of recurrence, often within 3 to 5 years. If pain recurs, the procedure can be repeated or an alternative procedure can be performed. Facial numbness is a common side effect, and may occur months or years after the procedure.

Other procedures may be used to treat trigeminal neuralgia, such as a rhizotomy. In a rhizotomy, your surgeon destroys nerve fibers to reduce pain, and this causes some facial numbness. Types of rhizotomy include:

  • Glycerol injection. During this procedure, your doctor inserts a needle through your face and into an opening in the base of your skull. Your doctor guides the needle into the trigeminal cistern, a small sac of spinal fluid that surrounds the trigeminal nerve ganglion — where the trigeminal nerve divides into three branches — and part of its root. Then, your doctor will inject a small amount of sterile glycerol, which damages the trigeminal nerve and blocks pain signals.

    This procedure often relieves pain. However, some people have a later recurrence of pain, and many experience facial numbness or tingling.

  • Balloon compression. In balloon compression, your doctor inserts a hollow needle through your face and guides it to a part of your trigeminal nerve that goes through the base of your skull. Then, your doctor threads a thin, flexible tube (catheter) with a balloon on the end through the needle. Your doctor inflates the balloon with enough pressure to damage the trigeminal nerve and block pain signals.

    Balloon compression successfully controls pain in most people, at least for a period of time. Most people undergoing this procedure experience at least some temporary facial numbness.

  • Radiofrequency thermal lesioning. This procedure selectively destroys nerve fibers associated with pain. While you're sedated, your surgeon inserts a hollow needle through your face and guides it to a part of the trigeminal nerve that goes through an opening at the base of your skull.

    Once the needle is positioned, your surgeon will briefly wake you from sedation. Your surgeon inserts an electrode through the needle and sends a mild electrical current through the tip of the electrode. You'll be asked to indicate when and where you feel tingling.

    When your neurosurgeon locates the part of the nerve involved in your pain, you're returned to sedation. Then the electrode is heated until it damages the nerve fibers, creating an area of injury (lesion). If your pain isn't eliminated, your doctor may create additional lesions.

    Radiofrequency thermal lesioning usually results in some temporary facial numbness after the procedure. Pain may return after three to four years.

What are the risk factors for fothergill disease?

Fothergill disease is a condition that makes one side of the face seem as though it has received an electric shock in terms of pain. The trigeminal nerve, which transmits feeling from your face to your brain, is impacted by this chronic pain syndrome. Fothergill disease patients may experience agonizing pain when even minor facial stimulation, such as tooth brushing or applying makeup, occurs.

At first, you can encounter brief, mild attacks. But it can worsen and lead to longer, more regular episodes of excruciating pain. Fothergill disease is more prevalent in women than in males, and it tends to strike adults over the age of 50.

Fothergill disease does not automatically guarantee a life of suffering due to the diversity of treatments available. Fothergill disease is typically successfully treated by doctors using drugs, injections, or surgery.


1. It is unclear what causes Fothergill illness exactly.
2. The trigeminal nerve is pressed against by a blood artery near the base of the brain in the majority of cases, which causes the condition.
3. The nerve may be harmed by the compression, which could also result in excessive neurological activity.
4. It is unclear why a blood artery ends up pushing against the trigeminal nerve.

Risk factors

1. It occurs more frequently in women than in men (1.74:1) and is most prevalent in people between the ages of 50 and 69.
2. Important risk factors for Fothergill disease include hypertension, arteriosclerotic vascular abnormalities, aging, individual susceptibility, familial history, and race

Shooting or jabbing pain,Spontaneous attacks of pain,Attacks of pain lasting from a few seconds to several minutes,Pain that occurs with facial spasms
Double vision,Jaw weakness,Loss of corneal reflex,Dysesthesia (troublesome numbness), and very rarely anesthesia dolorosa
Capsaicin,Carbamazepine,Gabapentin, Nabilone

Is there a cure/medications for fothergill disease?

The most agonizing pain ever experienced by humans is commonly referred to Fothergill disease as also known as tic douloureux. The lower face and jaw are often the areas of pain, though occasionally the nose and the area above the eye are also affected. The trigeminal nerve, which has branches that travel to the forehead, cheek, and lower jaw, is what is causing this excruciating, stabbing, electric shock-like pain. Fothergill disease can intensify over time if left untreated, even though attacks may start out moderate and brief.


Fothergill illness has no known treatment, however, it can help with your symptoms.

1. Nonsurgical Procedures: There are a number of efficient methods for reducing pain, including a number of drugs. Medication dosages are often begun at modest levels and then gradually increased based on the patient's response to the medication.

2. Surgery: Several surgical techniques may help manage the pain if drugs have failed to treat TN.

3. Lesioning Techniques: Electrocoagulation is used in the procedure of percutaneous radiofrequency rhizotomy to treat TN (heat). By eliminating the painful portion of the nerve and reducing the pain signal to the brain, it can reduce nerve pain. The trigeminal nerve is reached by the surgeon by inserting a hollow needle through the cheek.

4. Neuromodulation: Another surgical procedure that can be performed on TNP patients involves inserting one or more electrodes into the soft tissue close to the nerves, underneath the skull on the brain's covering, and occasionally deeper into the brain to deliver electrical stimulation to the area of the brain that controls facial sensation.

Shooting or jabbing pain,Spontaneous attacks of pain,Attacks of pain lasting from a few seconds to several minutes,Pain that occurs with facial spasms
Double vision,Jaw weakness,Loss of corneal reflex,Dysesthesia (troublesome numbness), and very rarely anesthesia dolorosa
Capsaicin,Carbamazepine,Gabapentin, Nabilone

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