The Trigeminal Neuralgia Program at Stanford Health Care brings together a multispecialty team highly trained in this complex and often debilitating condition. We work with you to develop a personalized treatment plan to provide relief and improve your quality of life.
What is trigeminal neuralgia?
Trigeminal neuralgia is a type of nerve pain that affects the face. People describe the feeling as intense bursts of electric shock-like pain that typically lasts anywhere from a few seconds to a few minutes. It can come and go for periods of days, weeks, or even months.
You may experience periods of relief between episodes of pain – this relief can last a year or more. However, you also may feel anxiety from the thought of the pain returning. In the most severe cases, episodes of pain can occur throughout the day with little or no relief between attacks.
What is the trigeminal nerve?
The trigeminal nerve is one of 12 pairs of cranial nerves that connect your brain to your head, neck, and torso. The trigeminal nerve is the fifth cranial nerve. It starts at the lower part of your brain and splits into three branches. The branches lead to the upper, middle, and lower parts of your face.
The role of the trigeminal nerve is to carry signals between your brain and face. This connection allows you to feel and move your facial muscles.
Connect to Care
Let us help find personalized care options for you and your family.
Understanding Trigeminal Neuralgia
Trigeminal Neuralgia Symptoms
Sharp, stabbing facial pain is the main symptom of trigeminal neuralgia, sometimes with facial muscle spasms. For some people, the pain is an underlying constant aching or burning pain. Flare-ups often begin with a tingling or numbness and progress to intense bursts of sharp pain. Pain attacks typically last from a few seconds to several minutes, and they can occur over and over for up to two hours.
Trigeminal neuralgia usually affects only one side of the face. In rare cases, it can affect both, although not at the same time.
The parts of the face most commonly affected by trigeminal neuralgia include:
- Upper jaw
- Lower jaw
- Teeth
- Cheeks
While it is less common, trigeminal neuralgia also can affect:
- Ears
- Eyes
- Forehead
- Lips
- Nose
Trigeminal neuralgia is progressive. Attacks of pain usually get worse over time, with fewer and shorter pain-free periods before they recur. Eventually, pain-free intervals disappear.
Anxiety is common in people with trigeminal neuralgia due to the fear of an attack. This fear can lead to social isolation.
Painful attacks of trigeminal neuralgia can sometimes occur suddenly, for no known reason. But often there is a trigger that causes the attack.
Common triggers of trigeminal neuralgia include:
- Brushing your teeth
- Chewing
- Smiling
- Drinking
- Feeling a light breeze
- Talking
- Touching your cheek, as when washing your face, shaving, or applying makeup
Causes of Trigeminal Neuralgia
Trigeminal neuralgia is usually caused by compression of the trigeminal nerve at the base of the brain. Most often, this is due to pressure from a blood vessel at the nerve root. A brain tumor can also compress the trigeminal nerve.
Trigeminal neuralgia can occur as a result of aging, or it can be related to multiple sclerosis or a similar disorder that damages the myelin sheath protecting certain nerves. Surgical injuries, stroke, or facial trauma may also be responsible for trigeminal neuralgia.
Trigeminal neuralgia may run in families, possibly because family members share an inherited pattern of abnormal blood vessel formation.
Types of Trigeminal Neuralgia
There are two main types of trigeminal neuralgia that vary based on the nature of the pain:
- Type 1 (classic trigeminal neuralgia): Attacks of electric shock-like pain
- Type 2 (atypical trigeminal neuralgia): A constant aching or burning pain
Risk Factors for Trigeminal Neuralgia
While the exact cause of trigeminal neuralgia is not known, doctors suspect it is most often caused by pressure on blood vessels at the root of the trigeminal nerve. This is the largest nerve in the head and is located close to the brain stem.
One of the following may produce pressure on the nerve:
- Tumor
- Aneurysm (enlarged artery resulting when its walls become weak)
- Arteriovenous malformation
- Multiple sclerosis
Prevention of Trigeminal Neuralgia
There is no known way to prevent trigeminal neuralgia. However, you may learn to avoid activities that trigger pain.
There is no specific test for trigeminal neuralgia. Diagnosis typically involves taking a detailed medical history and performing a physical examination to rule out other causes of facial pain. Your doctor will ask you about your symptoms, including:
- Location and type of pain
- Triggers that set off the pain
- What makes the pain better or worse
Trigeminal Neuralgia
Trigeminal neuralgia is a condition that causes attacks of intense facial pain, though some people may experience a constant aching or burning pain.
Trigeminal neuralgia
Facial pain
tic douloureux
trigeminal neuralgia treatment