Trigeminal neuralgia (2024)

FAQs

Trigeminal neuralgia? ›

Trigeminal neuralgia is a condition characterized by pain coming from the trigeminal nerve, which starts near the top of the ear and splits in three, toward the eye, cheek and jaw. We have two trigeminal nerves: one for each side of our face, but trigeminal neuralgia pain most commonly affects only one side.

Classical trigeminal neuralgia is caused by pressure on the trigeminal nerve close to where it enters the brain stem. The brain stem is the lowest part of the brain that merges with the spinal cord. In most cases the pressure is caused by an artery or vein squashing (compressing) the trigeminal nerve.

It is possible for the pain to then disappear completely and not recur for several months or years (a period known as “remission”). However, in severe cases, attacks may occur hundreds of times a day, and there may be no periods of remission.

What Is the Life Expectancy for Trigeminal Neuralgia? Trigeminal neuralgia is a chronic nerve pain disorder but it does not directly affect life expectancy and patients with the condition can live a normal life span.

Red flags such as progressive CN VII palsy or persistent CN V paraesthesia, numbness, formication or pain, particularly in the presence of immuno-compromise and/or a history of facial actinopathy should raise suspicion for PNS.

Pain episodes may be triggered by anything touching the face or teeth, including shaving, applying makeup, brushing teeth, touching a tooth or a lip with the tongue, eating, drinking or talking — or even a light breeze or water hitting the face.

Painkillers. For severe nerve pain, powerful opioid painkillers can help. Studies have found that for many types of nerve pain, they are as effective as anticonvulsants or antidepressants. Unlike other treatments for nerve pain, they also work very quickly.

Imaging tests such as an MRI may be ordered to rule out other conditions that also cause facial pain. “Trigeminal neuralgia is often diagnosed incorrectly. It can be confused with dental problems, headache syndromes, temporal arteritis, sinusitis and tumors of the brain or the face,” Dr. Friedman said.

This intense, stabbing, electric shock-like pain is caused by irritation of the trigeminal nerve, which sends branches to the forehead, cheek and lower jaw. It usually is limited to one side of the face. The pain can be triggered by an action as routine and minor as brushing your teeth, eating or the wind.

What happens if trigeminal neuralgia is left untreated? ›

Signals travelling through this trigeminal nerve cause debilitating and life-altering shock-like facial pain that lasts from seconds to hours. Initial episodes may be mild, but can worsen over time if left untreated.

Foods and drinks

Caffeine, citrus and bananas are known triggers. You may have other sensitivities, too. So avoid these foods and drinks.

Tricyclic antidepressants, such as amitriptyline (Elavil), doxepin (Sinequan), and nortriptyline (Pamelor). These drugs are prescribed for pain at doses lower than are effective for depression. Serotonin–norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta) and venlafaxine (Effexor).

Sometimes the pain may disappear completely and not return for several months or years. This is known as remission. In severe cases of trigeminal neuralgia the attacks may happen hundreds of times a day and there may be no periods of remission.

The first line of treatment for patients with trigeminal neuralgia is always medication. Even minimally invasive surgery carries risks and should be considered a last resort.

Trigeminal nerve damage can range from nerve irritation to a complete severing of the nerve. Injuries are classified as either recoverable (it can heal on its own) or non-recoverable (it cannot heal on its own).

Foods and drinks

Caffeine, citrus and bananas are known triggers. You may have other sensitivities, too. So avoid these foods and drinks.

Symptoms and Causes

There are several conditions that may cause trigeminal neuralgia, but it's typically caused by a blood vessel exerting pressure on the nerve near your brain stem. MS causes the deterioration of the nerve coating called the myelin sheath, so people with MS may also develop TN.