Understanding Trigeminal Neuralgia

What Is Trigeminal Neuralgia?

Ever have facial pain that hits out of the blue, causing short bursts of agony in the upper or lower jaw, cheek or forehead area? While numerous factors such as stress or dental problems can cause pain in these parts of the head, one often overlooked cause is trigeminal neuralgia.

Trigeminal neuralgia is caused by irritation of the trigeminal nerve. This nerve branches across the surface of the head and carries feelings from the forehead, middle face, mouth and jaw back to the brain.

Trigeminal neuralgia is more common in women, people 50 years of age or older and those who have multiple sclerosis (MS). In people with MS, trigeminal neuralgia can develop due to the degrading of the protective myelin coating of the trigeminal nerve. Other causes include trauma due to accident or surgery, pressure on the nerve caused by a blood vessel or, more rarely, a tumor.

Symptoms of Trigeminal Neuralgia

The main symptom of trigeminal neuralgia is pain.

Trigeminal neuralgia has two variants, known as T1 and T2. In T1, pain comes in short, intense bouts. These bouts can sometimes be triggered by touching a sensitive part of the mouth, jaw or face. In T2, the pain is more sustained. After an attack of trigeminal neuralgia, a patient may experience facial tremors or spasm.

Diagnosing Trigeminal Neuralgia

People with trigeminal neuralgia may think they have an abscessed tooth or a migraine. To determine what is causing facial pain, a doctor will go through the symptoms and medical history and perform a physical exam . After other causes have been ruled out, an MRI may be ordered to look for compression of the trigeminal nerve.

Treatments for Trigeminal Neuralgia at Tenet Health

Medical treatments for trigeminal neuralgia include:

  • Antiseizure medicines
  • Muscle relaxants
  • Tricyclic antidepressants

When medication no longer controls symptoms, surgery may be an option. He or she may suggest a procedure to damage or remove a portion of the nerve responsible for the pain. Procedures to treat trigeminal neuralgia include:

  • Balloon compression of the affected nerve
  • Injections of agents to damage nerve fibers
  • Microvascular decompression to move the nerve away from a blood vessel that may be pressing on it
  • Neurectomy, or surgically removing part of the affected nerve
  • Radiofrequency ablation to damage the nerve with heat
  • Stereotactic radiosurgery to create a scar that disrupts the nerve’s communication with the brain





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