Skip to Content

Trigeminal neuralgia

Definition

Trigeminal neuralgia is a nerve disorder that causes a stabbing or electric-shock-like pain in parts of the face.

Alternative Names

Tic douloureux

Causes

The pain of trigeminal neuralgia comes from the trigeminal nerve. This nerve carries pain, feeling, and other sensations from the brain to the skin of the face. It can affect part or all of the face, and the surface of the eye.

The condition usually affects older adults, but it may affect anyone at any age. Trigeminal neuralgia may be part of the normal aging process.

Trigeminal neuralgia may be caused by:

Often, no specific cause is found.

Doctors are more likely to find a cause if the patient is younger than age 40.

Symptoms

  • Very painful, sharp electric-like spasms that usually last a few seconds or minutes, but can become constant
  • Pain is usually only on one side of the face, often around the eye, cheek, and lower part of the face
  • Pain may be triggered by touch or sounds
  • Painful attacks of trigeminal neuralgia can be triggered by common, everyday activities, such as:
    • Brushing teeth
    • Chewing
    • Drinking
    • Eating
    • Lightly touching the face
    • Shaving

Exams and Tests

A neurologic examination is usually normal.

Tests that are done to look for the cause of the problem include:

Treatment

Your primary care physician, a neurologist, or a pain specialist may be involved in your care.

Certain medicines sometimes help reduce pain and the rate of attacks. These medicines include:

  • Anti-seizure drugs (carbamazepine, gabapentin, lamotrigine, phenytoin, valproate, and pregabalin)
  • Muscle relaxants (baclofen, clonazepam)
  • Tricyclic antidepressants (amitriptyline, nortriptyline, or carbamazepine)

Some patients may need surgery to relieve pressure on the nerve. Techniques include:

  • Cutting or destroying part of the trigeminal nerve
  • Stereotactic radiosurgery
  • Surgery to remove a blood vessel or tumor that is putting pressure on the trigeminal nerve

Outlook (Prognosis)

How well you do depends on the cause of the problem. If there is no underlying disease, some people find that treatment provides at least partial relief.

However, the pain may become constant and severe in some patients.

References

Cutrer FM, Moskowitz MA. Headaches and other head pain. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 421.

Goetz CG, ed. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: WB Saunders; 2007.

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.

Review Date: 6/16/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com

Disclaimer: The information contained in this website, and its associated websites, is provided as a benefit to the local community, and the Internet community in general; it does not constitute medical advice. We try to provide quality information, but we make no claims, promises or guarantees about the accuracy, completeness, or adequacy of the information contained in or linked to this website and its associated sites. As medical advice must be tailored to the specific circumstances of each patient and healthcare is constantly changing, nothing provided herein should be used as a substitute for the advice of a competent physician. Furthermore, in providing this service, Adventist HealthCare does not condone or support all of the content covered in this site. As an Adventist health care organization, Adventist HealthCare acts in accordance with the ethical and religious directives for Adventist health care services.

Adventist HealthCare · 301-315-3030 · 1801 Research BLVD, Suite 400, Rockville, MD 20850

Submit an Online Information Request