Trigeminal neuralgia (TN) is nerve pain in your face, teeth, mouth, or nose. You may have attacks of pain on one or both sides of your face. TN is also called tic douloureux.
Men and women of any age can have TN, but it happens most often in women over age 40.
The problem appears suddenly and may get better on its own. It may also disappear for months or years and then come back. The painful attacks may get more frequent as you get older.
What is the cause?
The exact cause is not known. The problem is thought to happen when a blood vessel presses on the trigeminal nerve. The trigeminal nerve has 3 branches that go to the upper, middle, and lower parts of your face. Other possible causes include multiple sclerosis, tumors, or injury to the trigeminal nerve.
An attack may happen after:
A light touch to the area
Brushing your teeth
Chewing or swallowing
Exposure to hot or cold air or drinks
What are the symptoms?
Symptoms may include severe stabbing or burning pain that comes in sudden jabs that last 1 to 15 minutes. The most common areas of pain are the cheeks and jaw. The frequency of the attacks varies from person to person. Between attacks, you may not have pain, but you may have a dull ache.
How is it diagnosed?
Your healthcare provider will ask about your symptoms and medical history and examine you. There are no tests to diagnose TN. You may have tests or scans to check for other possible causes of the symptoms.
How is it treated?
Different types of medicine may be prescribed by your healthcare provider to help relieve pain. It may be hard to find the best treatment if the painful attacks happen weeks or months apart. You may need to use more than 1 medicine to prevent or control your symptoms. Work with your provider to find the medicines that work best for you.
If medicine does not give relief, or side effects from the medicine are a problem, you may consider surgery. There are several kinds of surgery that may help, including removing part of the nerve. After surgery, parts of your face may be numb. The numbness may be temporary or permanent. If you no longer have feeling in that area, you must be very careful to watch for injuries or physical problems in that area such as:
Chewing-related problems, including gum and other dental problems
Newer treatments that may help are radiation or Botox injections to the nerve. It is possible to deliver radiation to just a small area of a nerve. You can ask if either of these treatments would be an option for you.
Some people may find pain is reduced or relieved by acupuncture, chiropractic adjustment, biofeedback, self-hypnosis, or meditation.
How can I take care of myself?
Keeping a pain diary may help you to see which activities or conditions cause your pain. Then you will know what you need to avoid.
Treating pain at the very first symptom may keep it from becoming as severe, and the pain may last a shorter time.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-05-01 Last reviewed: 2014-04-29
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.