Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentCoping
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Coping
Trigeminal neuralgia(a.k.a.tic douloureux) is a relatively rare facial pain syndrome. It affects a nerve in the head called thetrigeminal nerve, which provides sensation to the face.
The condition causes repeated episodes of sudden, extreme, electric-shock–like pain on the side of the face. Trigeminal neuralgia pain cycles can last months. It can also lead to anxiety over when the pain will return.
This article discusses trigeminal neuralgia symptoms and causes. It also covers the diagnosis and treatment of the condition and ways to cope.
boonchai wedmakawand / Getty Images
Trigeminal Neuralgia Symptoms
Severe facial pain that comes on abruptly is the main symptom of trigeminalneuralgia. The pain is often described as intensely sharp, stabbing, or electric shock-like.
It occurs as repetitive bursts of pain that may last for a few seconds or up to two minutes. The bursts come on more frequently until the pain is almost constant.
What Is the Trigeminal Nerve?The trigeminal nerve is acranial nerve(i.e., a nerve in the head). It starts at the ear and runs along both sides of the face in three branches:Above the eye socket: the ophthalmic branchAlong the cheekbone: the maxillary branchAlong the jaw: the mandibular branchThe nerve sends sensory information from the face to the brain and helps control the chewing muscles.
What Is the Trigeminal Nerve?
The trigeminal nerve is acranial nerve(i.e., a nerve in the head). It starts at the ear and runs along both sides of the face in three branches:Above the eye socket: the ophthalmic branchAlong the cheekbone: the maxillary branchAlong the jaw: the mandibular branchThe nerve sends sensory information from the face to the brain and helps control the chewing muscles.
The trigeminal nerve is acranial nerve(i.e., a nerve in the head). It starts at the ear and runs along both sides of the face in three branches:
The nerve sends sensory information from the face to the brain and helps control the chewing muscles.
Trigeminal neuralgia can affect any part of the face, but it is most common on the branches of the trigeminal nerve that run along the cheek and jaw. Typically, only one side of the face is effected.
The pain is often mistaken for toothache. Some people undergo painful and unnecessary dental procedures before getting an accurate diagnosis.
The course of a trigeminal neuralgia pain cycle is unpredictable. This can lead to anxiety and worry over when the next flare-up will strike.
Common Pain Triggers
During a pain cycle, certain common activities can trigger an episode of trigeminal neuralgia pain. These include:
RecapThe facial pain of trigeminal neuralgia comes on suddenly and is intense, stabbing, or like an electric shock. Bouts repeat in cycles that become more frequent and last for weeks or months. Flares can recur even after long periods of no symptoms.
Recap
The facial pain of trigeminal neuralgia comes on suddenly and is intense, stabbing, or like an electric shock. Bouts repeat in cycles that become more frequent and last for weeks or months. Flares can recur even after long periods of no symptoms.
The initial flare-up of trigeminal neuralgia often has no obvious cause. However, it can start after a car accident, dental work, or a blow to the face in some people.
Risk Factors
Trigeminal neuralgia is more common in some demographics than others. While it can affect people of any age, race, or sex, it is more likely to affect:
Trigeminal neuralgia does not typically run in families and is not believed to have a genetic component. However, about 2% of cases are found in people with a close relative with the condition. This is known as familial trigeminal neuralgia.
Conditions that trigeminal neuralgia may be confused with include:
About 150,000 people in the United States are diagnosed with trigeminal neuralgia each year.
Trigeminal neuralgia is usually treated with an anti-seizure medication called Tegretol (carbamazepine).While often effective, it does have side effects, which are worsened with higher doses.
Side effects include:
Some people are unable to take carbamazepine due to more serious adverse effects. These can include:
People of Asian descent, in particular, are at increased risk for Stevens-Johnson syndrome. Your healthcare provider may test you for a genetic marker before prescribing carbamazepine.
If you are unable to take carbamazepine, your healthcare provider may prescribe other medications. These include:
Specialist-Driven Procedures
Surgical treatments for trigeminal neuralgia include:
Alternative Treatments
Some people with trigeminal neuralgia find relief with complementary and alternative medicine therapies.
These include:
However, there is little or no evidence to support any of these approaches for trigeminal neuralgia pain relief. They may, however, help relieve anxiety and depression associated with trigeminal neuralgia flare-ups.
RecapTrigeminal neuralgia is commonly treated with medications used to treat seizures and muscle relaxers. If you cannot take these or they fail to work, surgery may be recommended. While some may find relief from alternative treatments, there is little evidence to show they help.
Trigeminal neuralgia is commonly treated with medications used to treat seizures and muscle relaxers. If you cannot take these or they fail to work, surgery may be recommended. While some may find relief from alternative treatments, there is little evidence to show they help.
Living with trigeminal neuralgia can be unpredictable. Many people who live with this painful condition often experience anxiety, worrying over when the pain will strike next.
Mind-body exercises, such as yoga, meditation, aromatherapy, and visualization, can lower your anxiety and help you cope better.
Support groups focused on people who live with facial pain syndromes or chronic pain can help you learn additional coping techniques and feel less alone.
These resources are good places to start:
Summary
Pain cycles get increasingly more intense and can last days to weeks. Patients can go long durations without pain only to have the condition flare again.
Seizure medications or muscle relaxers may be recommended. In some cases, surgery is needed to end the pain. Mind-body therapies and support can help you cope with worry about your next flare.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Johns Hopkins Medicine.Trigeminal neuralgia.
Zakrzewska JM, Linksey ME.Trigeminal neuralgia.BMJ.2014;348:g474. doi:10.1136/bmj.g474
American Association of Neurological Surgeons.Trigeminal neuralgia.
Cleveland Clinic.Trigeminal neuralgia.
Fernández Rodríguez B, Simonet C, Cerdán DM, Morollón N, Guerrero P, Tabernero C, Duarte J.Familial classic trigeminal neuralgia. Neurologia (Engl Ed). 2019;34(4):229-233. English, Spanish. doi:10.1016/j.nrl.2016.12.004
Al-Quliti KW.Update on neuropathic pain treatment for trigeminal neuralgia. The pharmacological and surgical options.Neurosciences (Riyadh). 2015;20(2):107–14. doi:10.17712/nsj.2015.2.20140501
Bajwa ZH, Ho CC, Khan SA. (2018). Trigeminal neuralgia. Shefner JM, Swanson JW, eds. UpToDate. Waltham, MA: UpToDate Inc.Gronseth G, Cruccu G, Alksne J, Argoff C, Brainin M, Burchiel K, et al.Practice parameter: the diagnostic evaluation and treatment of trigeminal neuralgia (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the European Federation of Neurological Societies.Neurology. 2008;71:1183-1190. doi: 10.1212/01.wnl.0000326598.83183.04Headache Classification Subcommittee of the International Headache Society. TheInternational Classification of Headache Disorders: 3rd Edition (beta version).Cephalalgia2013;24(9):629-808. doi: 10.1177/0333102413485658
Bajwa ZH, Ho CC, Khan SA. (2018). Trigeminal neuralgia. Shefner JM, Swanson JW, eds. UpToDate. Waltham, MA: UpToDate Inc.
Gronseth G, Cruccu G, Alksne J, Argoff C, Brainin M, Burchiel K, et al.Practice parameter: the diagnostic evaluation and treatment of trigeminal neuralgia (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the European Federation of Neurological Societies.Neurology. 2008;71:1183-1190. doi: 10.1212/01.wnl.0000326598.83183.04
Headache Classification Subcommittee of the International Headache Society. TheInternational Classification of Headache Disorders: 3rd Edition (beta version).Cephalalgia2013;24(9):629-808. doi: 10.1177/0333102413485658
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
