Trigeminal neuralgia (TN) is a rare but incredibly painful disorder. Characterized by intermittent electrical facial pain, trigeminal neuralgia can affect anyone. But it is more common in women than men and most often, it affects people ages 50 and older. Impacting roughly 200,000 Americans, trigeminal neuralgia has been called one of the most excruciatingly painful disorders. It can range from intermittent, mild symptoms to frequent and debilitating pain.
Trigeminal neuralgia can often be mistaken for other types of facial pain. But when properly diagnosed, 75 percent of trigeminal neuralgia sufferers find relief with medication, while 25 percent require surgery.
Trigeminal neuralgia is also referred to as tic douloureux. Several categorizing systems for facial pain have become popular in the mainstream, such as TN types 1 or 2. This can be confusing to patients when it doesn’t need to be. Basically, there are two primary types of facial pain: trigeminal neuralgia and trigeminal neuropathy (also often called atypical facial pain). The key to diagnosis lies in the nature of the pain, its constant or intermittent presence, and its potential to be triggered by common stimuli such as eating or talking. There appears to be a spectrum between classically described trigeminal neuralgia and neuropathic facial pain. Although these two entities are very different, many people lie somewhere on the spectrum between them.
FAQs About Trigeminal Neuralgia
Continue reading below to learn more about trigeminal neuralgia, or click on one of these links to go directly to the information that interests you.
- What causes trigeminal neuralgia?
- What are the symptoms of trigeminal neuralgia?
- How is trigeminal neuralgia (TN) different from other types of facial pain?
- How is trigeminal neuralgia properly diagnosed?
- Is trigeminal neuralgia (TN) life threatening?
- Is surgery the only way to treat trigeminal neuralgia?
- Are there support groups or other community organizations for people with trigeminal neuralgia?
What causes trigeminal neuralgia?
Trigeminal neuralgia, often called TN, can originate from a variety of conditions and has been linked to hypertension and multiple sclerosis. Trigeminal neuralgia is usually caused by a blood vessel at the base of the brain pressing against the trigeminal nerve, the largest cranial nerve responsible for sending impulses, including pain, pressure, touch, and temperature to the brain from the face, jaw, gums, forehead, and around the eyes. Over time, changes in the blood vessels of the brain can result in a blood vessel sagging and rubbing against the trigeminal nerve root. The constant rubbing with each heartbeat wears away the insulating membrane of the nerve, setting up a “short circuit” that results in facial pain.
Trigeminal neuralgia also, in rare cases, can be caused by compression of the nerve by a tumor or vascular malformation. In multiple sclerosis, a demyelinating plaque near the nerve’s entry into the brain can cause trigeminal neuralgia.
What are the symptoms of trigeminal neuralgia?
Trigeminal neuralgia, or TN, symptoms include:
- Sudden, severe, “shock-like” or stabbing pain
- Pain felt on only one side of the face
The attacks of pain can be cyclical and are unique to each sufferer, varying in length of attack and frequency of occurrences, ranging from pain experienced daily or monthly to pain that disappears for months or years. Trigeminal neuralgia pain is never constant.
The pain can permeate a small or larger part of the face and can sometimes be felt around the lips, eyes, nose, scalp, and/or forehead. Trigeminal neuralgia symptoms are typically triggered by contact with the face, such as when you are brushing your teeth, putting on makeup, touching your face, or swallowing. It can even happen when you feel a slight breeze, or when water hits your face in the shower.
Signs you may have trigeminal neuralgia:
- Shock-like pain that comes and goes suddenly
- Pain that occurs in cycles and may disappear for months or years
- Pain on one side of your face (although pain on both sides can also, rarely, be trigeminal neuralgia)
- Pain that is triggered by a touch or breeze to the face, or by eating/talking
How is trigeminal neuralgia (TN) different from other types of facial pain?
Trigeminal neuralgia is distinct with its sharp, electric, “shock-like” pain that comes and goes quickly and repeats itself in cycles. Neuropathic facial pain is a burning, dull pain that is more constant but may be accompanied rarely by sharp stabbing pains; it can be caused by trauma to the trigeminal nerve but often has no known cause.
How is trigeminal neuralgia properly diagnosed?
Nearly half all of trigeminal neuralgia sufferers are diagnosed with something else prior to a trigeminal neuralgia diagnosis. As such, unnecessary teeth extractions, sinus surgeries, and other medical procedures are often performed. By consulting the team at the Colorado Trigeminal Neuralgia Clinic early in the process, you can receive an accurate diagnosis and effective treatment options. We can work with your other medical providers to ensure that all treatment options are understood, giving you the choice in what is best for you.
To properly diagnose trigeminal neuralgia, or TN, a consultation at the Colorado Trigeminal Neuralgia Clinic at Neurosurgery One typically includes:
- Assessment of the patient’s medical history, reviewing all previous scans and assessments as necessary
- A neurological exam—a quick assessment of numbness, coordination, and strength
- Asking patients a series of questions that help identify trigeminal neuralgia (i.e. the character of the pain, triggers, responses to medications)
Patients typically undergo an MRI at some point after their diagnosis to rule out a tumor pressing on the nerve, which occurs in roughly 3 to 5 percent of cases.
After a diagnosis is made, we will help you understand all of your treatment options and refer you to the most appropriate specialist. If you already have a neurologist, we work closely with your doctor to assess your options and help you make a decision. If surgery is your best option, we offer three different procedures for trigeminal neuralgia so that we can choose the procedure that is best suited to your condition.
Is trigeminal neuralgia (TN) life threatening?
No, but it can greatly impact your quality of life and your mental health because it can be an excruciatingly painful condition. As such, it is important to visit the Colorado Trigeminal Neuralgia Clinic at Neurosurgery One as soon as you suspect you or a loved one might suffer from trigeminal neuralgia or other facial pain. The sooner you are diagnosed, the sooner you can find relief.
Is surgery the only way to treat trigeminal neuralgia?
No. In fact, 75 percent of all trigeminal neuralgia cases are effectively treated with medications, including anticonvulsants, muscle relaxants, and antidepressants. Only patients with trigeminal neuralgia that does not respond to medications or those unable to tolerate medications are referred for surgeries.
Are there support groups or other community organizations for people with trigeminal neuralgia?
Trigeminal neuralgia and facial pain and be perplexing issues. The more information and resources at your disposal, the better chance you have to find the support and treatment you need. Below are websites, blogs and videos that we recommend to help you better understand trigeminal neuralgia and facial pain.