Trigeminal neuralgia (TN) is a disorder of the trigeminal nerve (cranial nerve 5) that causes severe, shooting pain along one side of the face. The trigeminal nerve senses touch, pain, pressure, and temperature. It also helps make saliva and tears.
The Trigeminal Nerve
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In TN, pain usually lasts for less than a second to a few seconds and may come and go for days, weeks, months, or years. It may go into remission or stop completely for months or years between attacks. Over time, the attacks may become more frequent and more severe.
In most cases, the cause is unknown. In some, it may be caused by an abnormally formed artery or vein near the nerve. The blood vessel can compress the nerve and cause problems. Rarely, TN may occur as a symptom of another underlying disorder, such as:
The main symptom is searing pain on one side of the face. The pain may be felt inside the mouth or in the lips, cheek, chin, nostril, ear, or near the eye. Rarely, pain may occur in the eye or forehead. Twitching or wincing sometimes accompanies the pain.
The pain is typically sudden, severe, and stabbing. Even though the pain is brief, usually less than 2 minutes, it can reoccur hundreds of times a day. Attacks can become totally disabling. They may seem to occur at random or be triggered by extremes of temperature, washing, shaving, touching, or tickling the face. There are usually no symptoms between attacks, except perhaps a dull ache.
Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may have an electrophysiologic test called a trigeminal reflex test. Other tests, such as a CT scan or MRI scan can take evaluate the head and surrounding structures.
You may be given antiseizure medication to help diagnose the disorder.
Talk with your doctor about the best treatment plan for you. Options include:
Your doctor may recommend:
Surgery may be an option if medications fail to relieve symptoms. Microvascular decompression removes an artery or tumor that is pressing on the nerve. Other procedures may be used to cut the trigeminal nerve.
American Chronic Pain Association
The Facial Pain Association
CaTNA—The Canadian Trigeminal Neuralgia Association
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NINDS trigeminal neuralgia information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/trigeminal_neuralgia/trigeminal_neuralgia.htm. Updated November 30, 2012. Accessed June 28, 2013.
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Trigeminal neuralgia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114743/Trigeminal-neuralgia#sec-Overview-and-Recommendations. Updated May 29, 2014. Accessed September 12, 2016.
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11/29/2006 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Kanai A, Saito M, Hoka S. Subcutaneous sumatriptan for refractory trigeminal neuralgia. Headache. 2006;46(4):577-582.
Last reviewed May 2016 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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