Trigeminal Neuralgia

What is trigeminal neuralgia?

Trigeminal neuralgia, or tic douloureux, is a facial pain condition that affects your trigeminal nerve. This nerve is responsible for transmitting sensations from your mouth, teeth, face, and nasal cavity to your brain. It also controls the muscles you use to chew.

Women develop trigeminal neuralgia more often than men. Although it can occur at any age, it typically occurs over the age of 50. You may be at a higher risk if anyone in your family had trigeminal neuralgia, or if you have hypertension or multiple sclerosis.

What are the symptoms of trigeminal neuralgia?

The primary symptom of trigeminal neuralgia is pain — burning, sharp, jabbing, electric-shock pain. The pain occurs on one side of your face and typically involves your lower face and jaw.

When the symptoms first start, they may be short and mild. Over time, symptoms progress, becoming long, frequent bouts of extreme, searing pain. Eventually, you may have 12 or more attacks of stabbing pain every hour.

Many patients experience facial twitching caused by the pain. Your pain episodes may suddenly go into remission, but it's not permanent, and the pain eventually returns.

What triggers pain attacks?

When you have trigeminal neuralgia, a jolt of pain can be triggered by:

• Lightly touching your skin
• A light breeze brushing against your face
• Talking or smiling
• Brushing your teeth
• Shaving
• Washing your face
• Blowing your nose
• Drinking hot or cold beverages

How is trigeminal neuralgia treated?

Treatment for trigeminal neuralgia begins with anticonvulsant medications, which block nerve transmission to alleviate pain. While common analgesics aren’t helpful, tricyclic antidepressants often help with pain relief.

Over time, however, trigeminal neuralgia becomes resistant to medication. When medication no longer helps, two types of surgery may be performed:

• Open cranial surgery: Open cranial surgery is performed for patients who have pressure on the trigeminal nerve from a blood vessel. During this surgery, the trigeminal nerve root is exposed, and the blood vessel is moved away from the nerve. The procedure requires opening the skull to access the nerve root.
• Lesioning procedures: This treatment involves various procedures using heat, glycerol, and other methods to damage the nerve. As a result, the nerve stops transmitting nerve signals, but the effect is temporary, lasting for months to years.

If you develop shooting facial pain, call The Florida Center for Minimally Invasive Surgery, or book an appointment online.