Trigeminal neuralgia

Overview

Trigeminal neuralgia (try-JEM-ih-nul nu-RAL-juh) is a condition that causes intense pain similar to an electric shock on one side of the face. It affects the trigeminal nerve, which carries signals from the face to the brain. Even light touch from brushing your teeth or putting on makeup may trigger a jolt of pain. Trigeminal neuralgia can be long-lasting. It's known as a chronic pain condition.

People with trigeminal neuralgia may at first experience short, mild episodes of pain. But the condition can get worse, causing longer periods of pain that happen more often. It's more common in women and people older than 50.

But trigeminal neuralgia, also known as tic douloureux, doesn't mean living a life of pain. It usually can be managed with treatment.

Symptoms

Branches of the trigeminal nerve Enlarge image

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Branches of the trigeminal nerve

Branches of the trigeminal nerve

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 intense shooting or jabbing pain that may feel like an electric shock.
• Sudden episodes of pain or pain triggered by touching the face, chewing, speaking or brushing your teeth.
• Episodes of pain lasting from a few seconds to several minutes.
• Pain that occurs with facial spasms.
• Episodes of pain lasting days, weeks, months or longer. Some people have periods when they experience no pain.
• Pain in areas supplied by the trigeminal nerve. These areas include the cheek, jaw, teeth, gums or lips. Less often, the eye and forehead may be affected.
• Pain on one side of the face at a time.
• Pain focused in one spot. Or the pain may be spread in a wider pattern.
• Pain that rarely occurs while sleeping.
• Episodes of pain that become more frequent and intense over time.

When to see a doctor

See your healthcare professional if you experience pain in your face, particularly if it's long-lasting or comes back after going away. Also get medical attention if you have chronic pain that doesn't go away with pain medicine that you buy off the shelf.

Causes

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Trigeminal neuralgia

Trigeminal neuralgia

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

In trigeminal neuralgia, the trigeminal nerve's function is disrupted. Contact between a blood vessel and the trigeminal nerve at the base of the brain often causes the pain. The blood vessel may be an artery or a vein. This contact puts pressure on the nerve and doesn't allow it to function as usual.

But while compression by a blood vessel is a common cause, there are many other potential causes. Multiple sclerosis or a similar condition that damages the myelin sheath protecting certain nerves can cause trigeminal neuralgia. A tumor pressing against the trigeminal nerve also can cause the condition.

Some people may experience trigeminal neuralgia as a result of a stroke or facial trauma. An injury of the nerve due to surgery also can cause trigeminal neuralgia.

Triggers

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

• Shaving.
• Touching your face.
• Eating.
• Drinking.
• Brushing your teeth.
• Talking.
• Putting on makeup.
• A light breeze blowing over your face.
• Smiling.
• Washing your face.

Risk factors

Research has found that some factors put people at higher risk of trigeminal neuralgia, including:

• Sex. Women are more likely than men to experience trigeminal neuralgia.
• Age. Trigeminal neuralgia is more common among people 50 and older.
• Certain conditions. For example, hypertension is a risk factor for trigeminal neuralgia. In addition, people with multiple sclerosis are at higher risk of trigeminal neuralgia.