Trigeminal Neuralgia

• Symptoms

• Causes

• Diagnosis

• Treatment

• Preparation

• Outlook

What Is Trigeminal Neuralgia?

Trigeminal neuralgia (TN) is a painful, chronic condition involving the trigeminal nerve. There are about 12 cases per 100,000 people in the United States each year.

There are two separate trigeminal nerves, one on each side of the face. These nerves are responsible for carrying the sensation of pain and other sensations from the face to the brain. Each nerve has three branches (forehand, midface, and chin). It’s possible to have TN of any (or all) branches. TN causes intense pain in part or all of the face.

The pain can be brought on by mild stimulation of the face, such as brushing your teeth or shaving. It’s often described as feeling like electric shocks or stabbing. People with TN may initially have short, mild instances of pain, but over time they may experience longer, more frequent attacks of intense pain. Most people with TN experience symptoms in cycles — pain comes and goes for days or weeks, then subsides. In some cases, the condition becomes progressive and pain is always present.

There is no specific test for TN, so diagnosis can take time. Treatment depends on the cause and severity of the condition. Several medications are available to provide relief from pain and to decrease the number of episodes. Sometimes surgery is required.

Symptoms of Trigeminal Neuralgia

The pain of TN can come in sharp spasms that feel like electric shocks. Pain generally occurs on one side of the face and may be brought on by sound or touch. Pain can be triggered by routine acts, including:

• brushing your teeth

• shaving

• putting on makeup

• touching your face

• eating or drinking

• speaking

• a breeze on your face

You may experience bouts of pain that last only a few seconds or minutes. A series of attacks can last days, weeks, or months, followed by periods of remission.

The condition can progress, with attacks increasing in severity and frequency. In some cases, the pain or ache becomes constant.

Causes of Trigeminal Neuralgia

In many cases, the cause of TN is never found. However, known causes include:

• a swollen blood vessel or tumor that puts pressure on the nerve

• multiple sclerosis, a condition that damages the myelin sheath, which is the protective coating around nerves

According to the National Institute of Neurological Disorders and Stroke, although anyone can get TN, it’s more common among women than men. It’s also more common in people over the age of 50, although it can occur at any age.

How Trigeminal Neuralgia Is Diagnosed

There’s no single test that your doctor can order to help them diagnose TN. Diagnosis will depend on the type and location of the pain and factors that trigger the pain. Your doctor will first evaluate your medical history and perform a physical exam. This will include a neurological exam to determine which part of the trigeminal nerve is being affected. They will touch various parts of your face to determine the location of the pain.

Then they will order tests to rule out other conditions with similar symptoms, such as cluster headaches or postherpetic neuralgia, which is a painful condition that affects nerve fibers and skin. They may also order an MRI of your head, which can help determine whether multiple sclerosis is causing your pain.

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