What Is Trigeminal Neuralgia?

Trigeminal neuralgia is a condition that causes sudden, severe facial pain. It happens when the trigeminal nerve, which carries feeling from the face to the brain, becomes irritated or compressed.

The condition is often caused by pressure on the trigeminal nerve from a nearby blood vessel. Other possible causes include tumors or conditions such as multiple sclerosis that affect the protective covering of nerves.

Risk factors may include:

• Age over 50
• High blood pressure
• Multiple sclerosis
• Female sex

Many people describe the pain as sharp, stabbing, or similar to an electric shock. The condition often affects one side of the face and can interfere with daily activities like eating, talking, or brushing your teeth.

Symptoms

Trigeminal neuralgia can cause episodes of facial pain that come and go or become more constant over time. Even light movements or touch may trigger symptoms.

Common symptoms include:

• Sharp or shock-like facial pain
• Burning or stabbing sensations
• Pain in the jaw, cheek, lips, gums, or teeth
• Facial muscle twitching
• Pain triggered by chewing, speaking, shaving, or brushing teeth
• Sudden attacks lasting seconds to minutes

How Is It Diagnosed?

Diagnosing trigeminal neuralgia starts with a discussion about your symptoms and medical history. Your provider will also perform a neurological exam to better understand where the pain is coming from.

Imaging tests such as an MRI may be used to look for blood vessels, tumors, or other conditions affecting the trigeminal nerve. Testing also helps rule out other causes of facial pain, including dental problems, migraines, and TMJ disorders.

How Is It Treated?

Treatment usually begins with medication to calm irritated nerve signals and reduce pain episodes. Many people find relief with anticonvulsant medications commonly used for nerve pain.

If symptoms continue or medications stop working, additional treatment options may include:

• Minimally invasive procedures that interrupt pain signals
• Radiofrequency treatments that target the affected nerve fibers
• Microvascular decompression surgery to relieve pressure on the nerve
• Gamma Knife® radiosurgery, which uses focused radiation without traditional surgery

Recovery depends on the treatment used. Some procedures provide relief quickly, while others may take several weeks or months to reach full effect. Ongoing follow-up care can help manage symptoms and monitor for recurrence.