Trigeminal neuralgia is a condition that causes facial pain.  The trigeminal nerves or nucleus (their origin) send signals of severe pain to the brain.  The symptoms are often severe stabbing pain or electrical shocks.  Pain is on the side of the face, usually always one side, and comes in episodes.  The frequency and length of attacks is variable.  It can occur at any age, but is more common in those older than 50, and has multiple causes and treatments.

Causes of Trigeminal Neuralgia

Causes of trigeminal neuralgia are numerous.  It can be related to a variety of neuropathies, including multiple sclerosis and diabetes.  Vascular changes can cause pressure on the trigeminal nucleus and pain, and tumors can also affect the nerves.  In most cases, the cause is often not found, and may be a spontaneous problem, possibly due to a previous infection.

The main characteristic of trigeminal neuralgia is facial pain.  If a cause can be found, such as vascular compression or tumor, neurosurgical correction sometimes can lead to a cure.  However, in many cases, nothing can be found on diagnostic tests.  Treatment then is focused on management of pain symptoms and diminishing activities that irritate the region.

Facial Pain Management

Medication management is often the first line of treatment of trigeminal neuralgia.  Neuropathic medications are very effective for this condition.  The most common of these medications are drugs used for seizures.  It is often a trial and error method used to find the right medication and limit side affects.  Neurologists are often the first physicians managing the problems since they are experts in the diagnosis of nerve issues, and have extensive experience with prescribing these medications.

If the pain is not readily controlled with medications, a segment of those with trigeminal neuralgia are referred to a pain specialist.  The trigeminal nerve can be blocked and settled down with local anesthetic and steroid injections in some patients.  When injections work, relief can be almost instantaneous and put a patient in remission for months at a time.  If the relief is not prolonged but good, then ablation/destruction of the trigeminal nerve may also be effective.  The nerve can be abated several ways, including by a radiofrequency needle technique, special radiation, or surgery.

Good sources of additional reliable information on trigeminal neuralgia can be found through Mayo Clinic and the National Institutes of Health.

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