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NeurologicalICD-10: G50.0Affects approximately 4-13 per 100,000 people annually

Trigeminal Neuralgia

Trigeminal neuralgia is a chronic pain condition affecting the trigeminal nerve, which carries sensation from the face to the brain. It causes sudden, severe, shock-like or stabbing facial pain that can be triggered by everyday activities such as eating, talking, or even a light breeze. Often called the 'suicide disease' due to the intensity of the pain, trigeminal neuralgia most commonly affects people over 50 and is more prevalent in women.

Symptoms

Sudden episodes of severe, shooting, or stabbing pain on one side of the face
Pain triggered by touching the face, chewing, speaking, brushing teeth, or wind
Episodes lasting from a few seconds to several minutes
Pain concentrated in the cheek, jaw, teeth, gums, lips, or less often the eye and forehead
Clusters of attacks lasting days, weeks, or months followed by remission periods
A tingling or numbness sensation before pain onset (in some cases)

Causes

  • Compression of the trigeminal nerve by a blood vessel (usually the superior cerebellar artery)
  • Demyelination from multiple sclerosis damaging the trigeminal nerve sheath
  • Tumor or arteriovenous malformation pressing on the trigeminal nerve
  • Nerve damage from stroke, facial trauma, or surgical procedures

Risk Factors

  • Age over 50 years
  • Female sex
  • History of multiple sclerosis
  • High blood pressure (associated with vascular compression)
  • Family history of trigeminal neuralgia (rare genetic component)

Diagnosis

  • Detailed clinical history and neurological examination
  • MRI of the brain to identify vascular compression, tumors, or multiple sclerosis plaques
  • Magnetic resonance angiography (MRA) to visualize blood vessel-nerve relationships
  • Electrophysiological testing of trigeminal reflexes in atypical cases

Treatment

  • Anticonvulsant medications (carbamazepine, oxcarbazepine) as first-line treatment
  • Baclofen or lamotrigine as adjunctive or alternative therapy
  • Microvascular decompression surgery to relieve nerve compression
  • Percutaneous procedures (radiofrequency rhizotomy, balloon compression, glycerol injection)
  • Stereotactic radiosurgery (Gamma Knife) for patients unsuitable for open surgery
  • Botox injections for refractory cases

Prevention

  • No proven prevention, but avoiding known triggers can reduce attack frequency
  • Protect the face from cold wind and drafts
  • Eat soft foods and chew on the unaffected side during active episodes
  • Manage underlying conditions such as multiple sclerosis and hypertension

When to See a Doctor

  • You experience recurrent episodes of severe, electric shock-like facial pain
  • Facial pain is not controlled by over-the-counter pain medications
  • You develop new facial numbness, weakness, or other neurological symptoms

Frequently Asked Questions

Related Conditions

Migraine

Neurological

Depression

Mental Health

High Blood Pressure

Cardiovascular

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Medical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.

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