Trigeminal neuralgia is a neuropathic condition that causes intense pain across the face. The pain is usually caused by pressure on the trigeminal nerve, which is responsible for the sensation felt in the facial skin and upper half of the head.
Trigeminal neuralgia is characterized by a severe, sudden pain that is often described as resembling an electric shock. The pain may last for a few seconds to two minutes, in episodes that last anything from weeks to years. The condition usually only affects the right side of the face but in rare cases, individuals experience bilateral facial pain.
Types and causes
In around 80% to 90% of cases, trigeminal neuralgia is caused by pressure on the trigeminal nerve. Also known as the fifth cranial nerve, the trigeminal nerve has branches in three main areas: the lower jaw, the cheek and the forehead.
Trigeminal neuralgia is twice as common in women than in men and usually affects people in their 60s and 70s. The condition is categorized into three main types according to features of the pain it causes. These include:
Trigeminal neuralgia type 1 or classic trigeminal neuralgia – With this form of the condition, the pain is not constant and the cause cannot be identified.
Trigeminal neuralgia type 2 – Also called atypical trigeminal neuralgia, here the pain is more constant and usually causes a feeling of throbbing or burning.
Symptomatic trigeminal neuralgia – Symptomatic trigeminal neuralgia is pain that arises as a result of an underlying condition such as multiple sclerosis, for example.
This is a long-term condition that worsens with time and has no cure. Medication may provide temporary relief from pain, but overall the condition may have a severe impact on quality of life. Surgery may be considered in some cases, which involves either damaging the nerve slightly so that pain is no longer felt or alleviating the pressure placed on the nerve by surrounding blood vessels.
Reviewed by Sally Robertson, BSc