Trigeminal neuralgia (TN), or tic doloureux, is one of the most painful afflictions known. It affects about 15.000 new patients a year. Nearly all cases of typical TN are caused by blood vessels compressing the nerve. The relief of pain by carbamazepine gives more credit to the diagnosis of trigeminal neuralgia and the treatment. If drug treatment fails, surgical treatment to block pain signals from the nerve may be effective, Radio- frequency waves, gamma rays, or glycerol injections can deaden the nerve (and hence the pain). An operation the frees the nerve from whatever is compressing it (blood vessel or tumor) can permanently relieve pain.