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Trigeminal neuralgia (TN) is a problem with the trigeminal nerve. 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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In most cases, the cause is unknown. In some, it may be caused by an abnormally formed artery or vein near the nerve. The blood vessel can press on the nerve and cause problems.

Rarely, TN may happen as 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. Having multiple sclerosis may raise your risk.


The main symptom is searing pain on one side of the face. The pain may be felt inside the mouth or in the lips, cheek, chin, nostril, ear, or near the eye. Rarely, it may happen in the eye or forehead. Twitching or wincing may also happen.

The pain is sudden, severe, and stabbing. Even though the pain lasts less than 2 minutes, it can reoccur hundreds of times a day. Attacks can become totally disabling. They may seem to happen without notice or be triggered by temperature, washing, shaving, touching, or tickling the face. There may not be symptoms between attacks, except perhaps a dull ache.

Pain may come and go for days, weeks, months, or years. It may stop for months or years between attacks. Over time, the attacks may become more frequent and more severe.


Your doctor will ask about your symptoms and health history. A physical exam will be done.

You may have an electrophysiologic test called a trigeminal reflex test.

Other tests, such as an MRI scan can take pictures of the head and the structures around it.


Talk with your doctor about the best plan for you. Here are some options:


Your doctor may advise:

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


Surgery may be an option if other methods fail. Microvascular decompression removes an artery or tumor that is pressing on the nerve. Other surgeries may be used to cut the trigeminal nerve.


TN can’t be prevented.


American Chronic Pain Association

Facial Pain Association


Health Canada

Trigeminal Neuralgia Association of Canada


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Trigeminal neuralgia. EBSCO DynaMed Plus website. Available at: Updated March 20, 2018. Accessed June 25, 2018.

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Last reviewed May 2018 by EBSCO Medical Review Board Rimas Lukas, MD  Last Updated: 6/25/2018