Face / Head / Neck

Facial Pain (Trigeminal neuralgia)

What is trigeminal neuralgia?

Trigeminal neuralgia is a painful disorder of one of the nerves in your face, the trigeminal nerve.

Cause

The precise cause of trigeminal neuralgia is unknown. Experts think that it may be due to overstimulation of the trigeminal nerve, but in most cases, it is not known what causes this overstimulation. The most common cause is thought to be a blood vessel pressing on the nerve. In some cases, the cause may be a tumour or an inflammation (as in Multiple Sclerosis).

Signs and symptoms

Trigeminal neuralgia occurs more often in women than in men, and is mostly seen in people over 40. Patients with trigeminal neuralgia suffer brief but very severe stabbing pains in a particular part of their face, often near a corner of the mouth or a nostril. Patients sometimes describe the pain as being like an electric shock, or like a stab with a hot needle. The pains can be triggered by various stimuli or causes, such as wind blowing in one's face, washing, shaving, cold or heat, but also by chewing, speaking or swallowing. Trigeminal neuralgia often leads to weight loss, as patients may be too afraid to eat. Some patients have specific sensitive sites ('trigger points') on their face where even a light touch may provoke a pain attack. The complaints may be so serious that they seriously affect the patient's quality of life. The pains often occur over a particular period, after which they may disappear for a while. Some patients only have a few of these pain periods in their whole lifetime, while others have them far more often.

How is trigeminal neuralgia diagnosed?

The diagnosis is based on the pattern of the patient's symptoms. Physical examination usually shows no abnormalities. If you visit our clinic because of trigeminal neuralgia, you will always be given a neurological examination to exclude other possible causes of the pain. In addition, the doctor will test the mobility of your neck, to see whether certain movements are restricted or painful. The doctor will also feel your neck to see whether pressing on any of the vertebrae triggers pain.

Do I need additional examinations?

  • If you visit the clinic because of trigeminal neuralgia, you will always be given an MRI scan of the brain, to exclude other possible causes of the pain.

What are my treatment possibilities?

Physical Treatments

Medication

Interventional Pain Treatments

Invasive Treatments

Neurosurgical operation (Jannetta)