Trigeminal Neuralgia

Trigeminal neuralgia

What is trigeminal neuralgia?

Neuralgia is the medical term used to describe nerve pain. Trigeminal neuralgia is an extremely painful condition that affects the trigeminal nerve in the face, which is also called the fifth cranial nerve. The trigeminal nerve plays a very important role in the face, being responsible for sensing touch, pressure, pain and temperature in the jaw, gums, forehead and around the sensitive eye area. Since it controls sensation in almost the entire face, pain in the trigeminal nerve can affect many different parts of the face.

'Trigeminal neuralgia can affect virtually one whole side of the face.'

The pain can be triggered by simple activities such as shaving or washing the face. Occasionally a cold breeze blowing on the face can be enough to initiate an attack.

What causes it?

In the vast majority of cases of trigeminal neuralgia, the exact cause is unknown. In very rare cases, however, a cause may be found.

Among the causes are:

  • injury to the face, or oral surgery.
  • autoimmune disorders, in which the immune system attacks the person's own body. These include SLE (Lupus), Multiple Sclerosis and Scleroderma.
  • Herpes Zoster (Shingles), which is an extremely painful viral infection affecting the nerves.
  • an abnormality in the arteries or blood vessels which can result in compression of the nerve.
  • malignant or non-malignant tumours which may also compress the nerve.

Who is at risk?

Trigeminal neuralgia is more common among women than men. It rarely affects people under 50 years of age and there is no known way of preventing it.

How is it diagnosed?

There are no specific tests to diagnose trigeminal neuralgia. However, there is a very specific type of pain associated with this condition which will enable your GP to make a proper diagnosis. Some tests may be carried out in order to rule out other possible causes of facial pain such as diseases of the jaw, gums, teeth or sinuses.

How is it treated?

The condition is commonly treated with tegretol, an anti-seizure drug that is used in some forms of epilepsy. This works by stabilising the trigeminal nerve, thus relieving the pain.

If medication fails to control the pain it may become necessary to perform a nerve block. This involves direct injection of the trigeminal nerve resulting in the blockage of pain signals through the nerve.

In the rarer cases where the cause of trigeminal neuralgia is known, treatment of the underlying condition may stop the nerve pain.

What are the long-term effects?

The severe pain associated with trigeminal neuralgia - or even the fear of the pain - can have a very severe impact on the everyday life of a sufferer, sometimes making it virtually impossible for them to perform the most basic daily chores. It is unlikely that a sufferer would ignore this condition since the level of pain is quite severe. However, once it is diagnosed accurately it can be successfully treated.

Medication will usually make the pain disappear. If not, surgery will almost certainly stop the pain in the long-term. If the neuralgia is caused by another identifiable condition, treatment of the underlying cause will also stop the nerve pain.

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