Trigeminal neuralgia

Overview

Trigeminal neuralgia is a condition that causes painful sensations similar to an electric shock on one side of the face. This chronic pain condition affects the trigeminal nerve, which carries sensation from your face to your brain. If you have trigeminal neuralgia, even mild stimulation of your face — such as from brushing your teeth or putting on makeup — may trigger a jolt of excruciating pain.

You may initially experience short, mild attacks. But trigeminal neuralgia can progress and cause longer, more-frequent bouts of searing pain. Trigeminal neuralgia affects women more often than men, and it's more likely to occur in people who are older than 50.

Because of the variety of treatment options available, having trigeminal neuralgia doesn't necessarily mean that you're doomed to a life of pain. Doctors usually can effectively manage trigeminal neuralgia with medications, injections or surgery.

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 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

When to see a doctor

If you experience facial pain, particularly prolonged or recurring pain, or pain unrelieved by over-the-counter pain relievers, see your doctor.

Causes

Trigeminal neuralgia Enlarge image

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Trigeminal neuralgia

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.

Triggers

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