Trigeminal neuralgia is defined as nerve pain (neuralgia) involving one or more of the branches of the trigeminal nerves. The trigeminal nerve carries sensation from your face to your brain.
For most people with trigeminal neuralgia, the cause is a blood vessel pressing on the root of the trigeminal nerve. The trigeminal nerve (also called the fifth cranial nerve) is one of the main nerves of the face. There is one on each side. Much more rarely, trigeminal neuralgia is a symptom of another condition, like a tumour or multiple sclerosis.
How common is it?
Trigeminal neuralgia is uncommon. About 20 people in 100,000 develop it each year. It mainly affects older people, and it usually starts in your 60s or 70s. It is rare in younger adults. Women are more commonly affected than men.
What tests do I need?
The diagnosis of trigeminal neuralgia is often based on the typical symptoms and no tests are needed. However, a magnetic resonance imaging (MRI) scan may be considered in some cases, such as when:
- The diagnosis is in doubt (if the symptoms aren't typical of trigeminal neuralgia).
- An underlying cause is suspected (apart from the usual cause of a pressing blood vessel).
- Trigeminal neuralgia occurs in a younger person (younger than about 40 years).
- The condition does not improve with treatment.
- Surgery is being considered as a treatment.
Are there any complications?
The pain itself can be very severe and distressing. If left untreated, this may make you feel very depressed and anxious. You may neglect to clean your teeth or not eat for fear of triggering the pain. This can then lead to poor diet, weight loss and poor mouth hygiene.
In the small number of cases where trigeminal neuralgia occurs as a result of another condition (for example, multiple sclerosis), there will usually be symptoms and complications caused by that condition.
Further reading and references
Trigeminal neuralgia; NICE CKS, December 2014 (UK access only)
Deep brain stimulation for intractable trigeminal autonomic cephalalgias; NICE Interventional Procedure Guideline, March 2011
Montano N, Conforti G, Di Bonaventura R, et al; Advances in diagnosis and treatment of trigeminal neuralgia. Ther Clin Risk Manag. 2015 Feb 2411:289-99. doi: 10.2147/TCRM.S37592. eCollection 2015.
Zakrzewska JM, Linskey ME; Trigeminal neuralgia. BMJ. 2014 Feb 17348:g474. doi: 10.1136/bmj.g474.
Zhang J, Yang M, Zhou M, et al; Non-antiepileptic drugs for trigeminal neuralgia. Cochrane Database Syst Rev. 2013 Dec 312:CD004029. doi: 10.1002/14651858.CD004029.pub4.
Parmar M, Sharma N, Modgill V, et al; Comparative Evaluation of Surgical Procedures for Trigeminal Neuralgia. J Maxillofac Oral Surg. 2013 Dec12(4):400-409. Epub 2012 Nov 29.
Hi this is my first post. I am a 66 yr old woman in Australia and would like some advice? Is there a "natural" old fashioned remedy for trigeminal neuralgia. I am having severe pain on the left side...sheilagh46696
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