Trigeminal neuralgia is a chronic pain condition affecting the trigeminal nerve, which carries sensation from the face to the brain. It causes sudden, severe, stabbing or electric shock like pain in the face, typically on one side. Episodes can be triggered by ordinary activities and can be profoundly disabling.
The condition most commonly develops after age 50 and affects women more often than men. While initial episodes may be brief and infrequent, trigeminal neuralgia tends to worsen over time without treatment.
What the Pain Feels Like
Trigeminal neuralgia pain is distinctive. It is often described as one of the most intense pain experiences known, frequently compared to an electric shock hitting one side of the face.
- Sudden, severe, stabbing or electric shock like facial pain lasting seconds to minutes
- Pain triggered by chewing, talking, brushing teeth, shaving, or touching the face
- Pain triggered by wind or cold air on the face
- Episodes that cluster over weeks or months, followed by periods of remission
- Pain typically confined to one side of the face
- Pain along the distribution of the trigeminal nerve (cheek, jaw, teeth, gums, lips, or around the eye)
Finding the Right Treatment
Trigeminal neuralgia is diagnosed based on the characteristic pain pattern and response to specific medications. MRI of the brain is performed to evaluate for vascular compression of the trigeminal nerve and to exclude other causes such as tumors or multiple sclerosis. Treatment begins with medication (typically carbamazepine or oxcarbazepine). When medication becomes ineffective or causes intolerable side effects, surgical options include microvascular decompression, which addresses the root cause of the pain.