Trigeminal neuralgia (TN) is a nerve disorder. It causes a stabbing or electric shock-like pain in parts of the face.
Tic douloureux; Cranial neuralgia; Facial pain - trigeminal; Facial neuralgia; Trifacial neuralgia; Chronic pain - trigeminal; Microvascular decompression - trigeminal
The pain of TN comes from the trigeminal nerve. This nerve carries the sensations of touch and pain from the face, eyes, sinuses, and mouth to the brain.
Trigeminal neuralgia may be caused by:
Often, no cause is found. TN usually affects adults, but it can occur at any age. When TN affects people younger than 40, it is often due to MS or a tumor.
Symptoms may include any of the following:
Painful attacks of trigeminal neuralgia can be triggered by common, everyday activities, such as talking, brushing teeth, chewing, drinking, eating, touching the face, or shaving.
Exams and Tests
A brain and nervous system (neurologic) examination is often normal. Tests that are done to look for the cause may include:
Your primary care doctor, 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:
Surgery is an option for TN. But, the true benefits of surgery are not fully proven.
One surgery is called microvascular decompression (MVD). During surgery, material is placed between the nerve and the blood vessel that is pressing on the nerve.
Other techniques involve destroying or cutting parts of the trigeminal nerve root. Methods used include:
If a tumor is the cause of TN, surgery is done to remove it.
How well you do depends on the cause of the problem. If there is no disease causing the problem, treatment can provide some relief.
In some people, the pain becomes constant and severe.
Complications may include:
When to Contact a Medical Professional
Call your health care provider if you have symptoms of TN, or your TN symptoms get worse.
Garza I, Schwedt TJ, Robertson CE, Smith JH. Headache and other craniofacial pain. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 103.
Paterno J, Singla A. Trigeminal neuralgia. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 117.
Zakrzewska JM, Chen HI, Lee JYK. Trigeminal and glossopharyngeal neuralgia. In: McMohan SB, Koltzenburg M, Tracey I, Turk DC, eds. Wall & Melzack's Textbook of Pain. 6th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 66.
Review Date: 5/30/2016
Reviewed By: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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