Trigeminal Neuralgia: Symptoms, Causes, and Treatment

Trigeminal neuralgia is often mistaken for a toothache, leading to unnecessary diagnostic procedures—such as jaw X-rays—and, in many cases, the needless extraction of teeth. Therefore, it is crucial to understand its symptoms and seek timely treatment to prevent serious complications.

Things You Will Need

• N/A

Method

What Are the Symptoms?

In trigeminal neuralgia, episodes of pain begin and end abruptly; they are brief in duration but extremely intense. The pain is typically felt on only one side of the face. It may be described as a stabbing sensation or similar to an electric shock. These pain attacks can last for up to 2 minutes, though in most patients, they persist for only a few seconds. The frequency of these attacks can range from zero to over 50 times per day. Approximately 63% of patients experience periods of complete pain relief. These pain-free intervals can last anywhere from a few weeks to several years.

What Are the Causes?

 Trigeminal neuralgia is often caused by a blood vessel lying in very close proximity to the trigeminal nerve. The pulsation of this blood vessel repeatedly presses against the nerve, causing the patient to experience sudden, intense pain—either as a headache or pain affecting one side of the face—lasting for a few seconds, multiple times throughout the day. MRI is the most widely used diagnostic tool for assessing trigeminal neuralgia, as it is highly sensitive in detecting other major neurological conditions, such as tumors.

What Are the Triggers?

• Touching the face
• Brushing teeth
• Wiping the face with a towel
• Exposure to a strong gust of wind on the face
• Shaving
• Chewing food
• Applying makeup

The pain may feel as though it is radiating outward, similar to sciatica.

Treatment

Most cases can be managed with medication. However, patients whose MRI scans reveal compression of the nerve typically require surgery.