Trigeminal neuralgia is a nerve disorder that causes a stabbing or electric-shock-like pain in parts of the face.
Causes, incidence, and risk factors
The pain of trigeminal neuralgia comes from the trigeminal nerve. This nerve carries pain, feeling, and other sensations from the brain to the skin of the face. It can affect part or all of the face, and the surface of the eye.
The condition usually affects older adults, but it may affect anyone at any age. Trigeminal neuralgia may be part of the normal aging process.
Trigeminal neuralgia may be caused by:
- Multiple sclerosis
- Pressure on the trigeminal nerve from a swollen blood vessel or tumour
Often, no specific cause is found.
Symptoms
Very painful, sharp electric-like spasms that usually last a few seconds or minutes, but can become constant
Pain is usually only on one side of the face, often around the eye, cheek, and lower part of the face. Pain may be triggered by touch or sounds. Painful attacks of trigeminal neuralgia can be triggered by common, everyday activities, such as:
- Brushing teeth
- Chewing
- Drinking
- Eating
- Lightly touching the face
- Shaving
Signs and Tests
A neurologic examination is usually normal.
Tests that are done to look for the cause of the problem include:
- Blood tests
- MRI of the head
- Trigeminal reflex testing
Treatment
Certain medicines sometimes help reduce pain and the rate of attacks.
These medicines include:
- Anti-seizure drugs
- Muscle relaxants
- Tricyclic antidepressants
Some patients may need surgery to relieve pressure on the nerve.
Techniques include:
- Cutting or destroying part of the trigeminal nerve
- Stereotactic radiosurgery
- Surgery to remove a blood vessel or tumour that is putting pressure on the trigeminal nerve
Expectations
How well you do depends on the cause of the problem. If there is no underlying disease, some people find that treatment provides at least partial relief.
However, the pain may become constant and severe in some patients.
