Trigeminal neuralgia - Symptoms and causes (2024)

Overview

Trigeminal neuralgia (try-JEM-ih-nul nu-RAL-juh) is a condition that causes intense pain similar to an electric shock on one side of the face. It affects the trigeminal nerve, which carries signals from the face to the brain. Even light touch from brushing your teeth or putting on makeup may trigger a jolt of pain. Trigeminal neuralgia can be long-lasting. It's known as a chronic pain condition.

People with trigeminal neuralgia may at first experience short, mild episodes of pain. But the condition can get worse, causing longer periods of pain that happen more often. It's more common in women and people older than 50.

But trigeminal neuralgia, also known as tic douloureux, doesn't mean living a life of pain. It usually can be managed with treatment.

Symptoms

Branches of the trigeminal nerve

Trigeminal neuralgia - Symptoms and causes (1)

Branches of the trigeminal nerve

Trigeminal neuralgia results in pain occurring in an area of the face supplied by one or more of the three branches of the trigeminal nerve.

Trigeminal neuralgia symptoms may include one or more of these patterns:

  • Episodes of intense shooting or jabbing pain that may feel like an electric shock.
  • Sudden episodes of pain or pain triggered by touching the face, chewing, speaking or brushing your teeth.
  • Episodes of pain lasting from a few seconds to several minutes.
  • Pain that occurs with facial spasms.
  • Episodes of pain lasting days, weeks, months or longer. Some people have periods when they experience no pain.
  • Pain in areas supplied by the trigeminal nerve. These areas include the cheek, jaw, teeth, gums or lips. Less often, the eye and forehead may be affected.
  • Pain on one side of the face at a time.
  • Pain focused in one spot. Or the pain may be spread in a wider pattern.
  • Pain that rarely occurs while sleeping.
  • Episodes of pain that become more frequent and intense over time.

When to see a doctor

See your healthcare professional if you experience pain in your face, particularly if it's long-lasting or comes back after going away. Also get medical attention if you have chronic pain that doesn't go away with pain medicine that you buy off the shelf.

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Causes

Trigeminal neuralgia

Trigeminal neuralgia - Symptoms and causes (2)

Trigeminal neuralgia

Trigeminal neuralgia is caused by a disruption in the trigeminal nerve's function.

In trigeminal neuralgia, the trigeminal nerve's function is disrupted. Contact between a blood vessel and the trigeminal nerve at the base of the brain often causes the pain. The blood vessel may be an artery or a vein. This contact puts pressure on the nerve and doesn't allow it to function as usual.

But while compression by a blood vessel is a common cause, there are many other potential causes. Multiple sclerosis or a similar condition that damages the myelin sheath protecting certain nerves can cause trigeminal neuralgia. A tumor pressing against the trigeminal nerve also can cause the condition.

Some people may experience trigeminal neuralgia as a result of a stroke or facial trauma. An injury of the nerve due to surgery also can cause trigeminal neuralgia.

Triggers

Several triggers may set off the pain of trigeminal neuralgia, including:

  • Shaving.
  • Touching your face.
  • Eating.
  • Drinking.
  • Brushing your teeth.
  • Talking.
  • Putting on makeup.
  • A light breeze blowing over your face.
  • Smiling.
  • Washing your face.

Risk factors

Research has found that some factors put people at higher risk of trigeminal neuralgia, including:

  • Sex. Women are more likely than men to experience trigeminal neuralgia.
  • Age. Trigeminal neuralgia is more common among people 50 and older.
  • Certain conditions. For example, hypertension is a risk factor for trigeminal neuralgia. In addition, people with multiple sclerosis are at higher risk of trigeminal neuralgia.

By Mayo Clinic Staff

Dec. 28, 2023

Trigeminal neuralgia - Symptoms and causes (2024)

FAQs

What is the main cause of trigeminal neuralgia? ›

Causes of Trigeminal Neuralgia

The condition may be caused by a blood vessel pressing against the trigeminal nerve, also known as vascular compression. Over time, the pulse of an artery rubbing against the nerve can wear away the insulation, which is called myelin, leaving the nerve exposed and highly sensitive.

What is the trigger of trigeminal neuralgia? ›

Trigeminal neuralgia symptom triggers

It's mostly simple activities that require you to move or touch your face that can trigger painful TN episodes, including: Shaving, putting on makeup or washing your face. Eating and drinking.

What factors cause trigeminal neuralgia? ›

Although the exact cause of trigeminal neuralgia is not known, it can be caused by damage to the lining of the nerve. It may also be the result of an artery or a vein pushing against the trigeminal nerve. This can happen naturally as a person gets older, or it can also be caused by an injury or stroke.

What conditions are mistaken for trigeminal neuralgia? ›

Imaging tests such as an MRI may be ordered to rule out other conditions that also cause facial pain. “Trigeminal neuralgia is often diagnosed incorrectly. It can be confused with dental problems, headache syndromes, temporal arteritis, sinusitis and tumors of the brain or the face,” Dr. Friedman said.

What is a red flag for trigeminal neuralgia? ›

Red flags such as progressive CN VII palsy or persistent CN V paraesthesia, numbness, formication or pain, particularly in the presence of immuno-compromise and/or a history of facial actinopathy should raise suspicion for PNS.

What causes the trigeminal nerve to flare up? ›

Trigeminal Neuralgia Triggers

Though what triggers acute attacks will vary from patient to patient, common activities that cause trigeminal neuralgia to ramp up include: Hot, cold, spicy, or sour foods and beverages. Brushing your teeth. Gentle touch, including a breeze or face washing.

How to calm down trigeminal neuralgia? ›

To treat trigeminal neuralgia, healthcare professionals prescribe medicines to lessen or block the pain signals sent to your brain.
  1. Anti-seizure medicines. Healthcare professionals often prescribe carbamazepine (Tegretol, Carbatrol, others) for trigeminal neuralgia. ...
  2. Muscle relaxants. ...
  3. Botox injections.
Dec 28, 2023

What not to do with trigeminal neuralgia? ›

Painful attacks of trigeminal neuralgia can be triggered by common, everyday activities, such as:
  • Talking.
  • Smiling.
  • Brushing teeth.
  • Chewing.
  • Drinking.
  • Eating.
  • Exposure to hot or cold temperature.
  • Touching the face.

Is trigeminal neuralgia brought on by stress? ›

While stress alone doesn't cause trigeminal neuralgia, stress can aggravate the condition. There isn't a lot of understanding about how or why, but one possibility is the relationship between stress and pain. Studies have shown that chronic pain can lead to stress-induced heightened pain sensitivity.

What autoimmune disease causes trigeminal neuralgia? ›

Causes of Trigeminal Neuralgia

Multiple sclerosis: This is an autoimmune disorder that can damage the protective covering of the trigeminal nerve, leading to TN. Tumors: A tumor pressing against the trigeminal nerve can result in TN.

What else can mimic trigeminal neuralgia? ›

Upon clinical examination most of these can be ruled out; however, conditions such as cluster headache, short lasting, unilateral, neuralgiform pain with conjunctival injection and tearing (SUNCT), chronic paroxysmal hemicrania (CPH), cracked tooth syndrome, jabs and jolts syndrome, giant cell arteritis and post- ...

Does trigeminal neuralgia turn into MS? ›

In Conclusion. It is clear that there is a strong connection between multiple sclerosis and trigeminal neuralgia. The two conditions often occur together and patients with one disease are especially likely to develop the other. However, not everyone affected by one or the other will develop both conditions.

What is the best medication for trigeminal neuralgia? ›

The anti-convulsant drug most commonly prescribed for trigeminal neuralgia is carbamazepine (Tegretol), which can provide at least partial pain relief for up to 80 to 90 percent of patients. Other anti-convulsants prescribed frequently for trigeminal neuralgia include: Phenytoin (Dilantin)

What is the best painkiller for neuralgia? ›

What pain reliever is best for nerve pain?
  • gabapentinoids — a subclass of anticonvulsants (gabapentin, pregabalin)
  • tricyclic antidepressants (amitriptyline)
  • selective-serotonin-norepinephrine reuptake inhibitors (duloxetine, venlafaxine)
Mar 6, 2023

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