Definition

Trigeminal neuralgia (TN) is pain in the trigeminal nerve of the head. The nerve senses touch, pain, pressure, and temperature. It also helps make saliva and tears. TN causes severe, shooting pain along one side of the face.

The Trigeminal Nerve
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Causes

The cause is not always known. It may be due to an abnormally formed artery or vein near the nerve. The blood vessel can press on the nerve and cause problems.

TN may also be a symptom of another health problem, such as:

Risk Factors

TN is more common in women. It is also more common in people aged 50 years or older.

Symptoms

The main symptom is sudden, severe, and stabbing pain on one side of the face. Other problems may be:

  • Pain that is felt in the inside of the mouth or in the lips, cheek, chin, nostril, ear, or near the eye
  • Twitching or wincing
  • Pain that is triggered by things like shaving, washing, or tickling the face
  • Pain in the eye or forehead (rare)

The pain may last less than two minutes. It can happen hundreds of times a day and make it hard to do daily activities. It may come and go for days, weeks, months, or years. It may also get worse over time.

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done.

A trigeminal reflex test may be done to check nerve function.

Other tests, such as an MRI scan can take pictures of the head and the structures around it. This can help look for other causes.

Treatment

The goal of treatment is to ease pain. This may be done with medicines, such as:

  • Antiseizure medicine
  • Muscle relaxants
  • Antidepressants
  • Nasal sprays
  • Injections

Some people may need surgery when other methods do not help. Microvascular decompression removes an artery or tumor that is pressing on the nerve. Other surgeries may be used to cut the trigeminal nerve.

Prevention

There are no known ways to prevent TN.

RESOURCES:

American Chronic Pain Association
http://www.theacpa.org

Facial Pain Association
http://fpa-support.org

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca

Trigeminal Neuralgia Association of Canada
http://tnac.org/tnac

REFERENCES:

Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211.

Trigeminal neuralgia information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Trigeminal-Neuralgia-Fact-Sheet. Accessed October 7, 2020.

Trigeminal neuralgia. American Academy of Neurological Surgeons website. Available at: https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Trigeminal-Neuralgia. Accessed October 7, 2020.

Trigeminal neuralgia. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/trigeminal-neuralgia. Accessed October 7, 2020.

Last reviewed September 2020 by EBSCO Medical Review Board Rimas Lukas, MD  Last Updated: 10/7/2020