Trigeminal Neuralgia

What is trigeminal neuralgia?

Trigeminal neuralgia is a condition in which a dysfunctional facial nerve causes persistent or recurring facial pain. Women older than 40 years of age are most commonly affected by this condition. The condition is characterized by attacks of sudden, sharp, shooting pain in some parts of the face. It is most commonly one-sided, around the eye, cheek, jaws or the lower parts of the face and triggered by movements like smiling, chewing and more. The diagnosis is mostly made based on the symptoms and physical examination. Treatment involves medication to reduce the pain, and, if applicable, surgery. Although the pain can be difficult to control, many people find relief with a combination of therapies.

Risks

Trigeminal neuralgia is pain which comes from the trigeminal nerve (neuralgia means 'nerve pain'). The trigeminal nerve carries feeling from the facial skin to the brain, and controls the muscles needed for chewing. In many cases, there is no obvious cause for the pain. Sometimes trigeminal neuralgia occurs as the result of another medical condition, such as multiple sclerosis (MS), or a tumor that is pressing on the nerve. Although anyone can develop trigeminal neuralgia, it is more common in people older than 40. It is more common in women than men.

Symptoms

The typical symptom is a very strong, sharp and electric pain of the face. This typically comes from the ear and spreads around the eye, and over the cheek, jaw and chin. This pain is usually only present on one side of the face, though it can occur on both sides in some cases. The pain tends to come in short-lived, 'electric shock'-like bursts. Talking, smiling, chewing, light touch on the face, swallowing and kissing can trigger the pain, though some people have pain without any trigger at all. As the pain is located in the jaw, teeth or gums, it can be mistaken for tooth pain.

Diagnosis

The diagnosis is based on the symptoms and physical examination. Imaging of the head, such as with a CT scan or MRI scan, are usually done to exclude other causes for the pain, like MS or a tumor.

Treatment

Treatment of trigeminal neuralgia involves treating the underlying cause, if there is one, and managing the pain. Many people find that normal pain medications don't help, so some medications which specifically target nerve pain are used. These include anti-seizure medications and muscle relaxants. are known to show good effects. If these are not effective, a procedure to destroy the part of the trigeminal nerve or remove small blood vessels around the nerve may be needed.

Prevention

Avoiding triggers can reduce the rates of attack.

Other names for trigeminal neuralgia

  • Fothergill's disease
  • prosopalgia