HealthInfo Aoraki South Canterbury

Trigeminal neuralgia

Mamae karioi ki te akaaka angaanga

Trigeminal neuralgia is a pain condition affecting your trigeminal nerves.

Your trigeminal nerves control the feeling on each side of your face. Each nerve starts at your ear then divides into three branches:

• the ophthalmic, which supplies sensation to your forehead and nose
• the maxillary, which supplies your cheek above your mouth
• the mandibular, which supplies your jaw, your temple and in front of your ear.

Trigeminal neuralgia is when the nerve sends sudden severe electric-shock-like bursts of pain that you feel on one side of your face. The pain comes in waves or bouts and can occur hundreds of times a day, or just now and again.

Several things can trigger the pain, including brushing your hair, a breeze blowing on your face, chewing food, brushing your teeth or talking.

The pattern of pain depends on which branch of your nerve is affected. If your ophthalmic branch is affected, you may also have a runny nose, tearing or redness in your eye.

Usually, the pain goes away when the attack is finished. Some people feel a dull ache that remains between attacks.

Trigeminal neuralgia affects women more often than men and is more likely to occur over the age of 50. People who have high blood pressure or get migraines seem to be at a higher risk of developing trigeminal neuralgia.

For most people, trigeminal neuralgia comes and goes in an unpredictable pattern over many years. This can mean days or months of spasms of pain followed by long periods without pain.

Causes of trigeminal neuralgia

We do not know the exact cause of trigeminal neuralgia, but it's thought to be caused by compression (pressure) or damage to the trigeminal nerve.

The trigeminal nerve can be compressed or damaged by:

• a blood vessel such as an artery or a vein – this is the most common cause
• a tumour or a cyst
• a degenerative nerve condition such as multiple sclerosis
• a facial injury
• surgery or a dental procedure.

Diagnosing trigeminal neuralgia

There are no tests for trigeminal neuralgia. Your general practice team can diagnose it by examining you and asking you about your symptoms.

Treating trigeminal neuralgia

Treatment for trigeminal neuralgia usually involves taking medication daily to reduce the painful messages that the nerve is sending to your brain.

The most effective medication for trigeminal neuralgia is carbamazepine. It's usually used for treating epilepsy but it's also effective at treating nerve pain. There are also other options if this doesn't work.

Some people do not get better with medication and need surgery to remove pressure on the nerve. Talk to your general practice team about whether this might be an option for you.

Living with trigeminal neuralgia can affect your quality of life and be distressing. Talk through your feelings with your whānau (family) and friends to get the support you need. You can also join a support group that shares information about trigeminal neuralgia such as Trigeminal Neuralgia New Zealand.

  HealthInfo recommends the following pages

• Patient.info – Trigeminal neuralgia

  Find out more about the trigeminal nerve and treatment options.

• NHS – Trigeminal neuralgia

  How to avoid triggers and medication options.

• Trigeminal Neuralgia New Zealand – Facebook group

  A group of like-minded people living in New Zealand who share information and ask questions of each other's pain, medications, doctors and surgeons.

Written by HealthInfo clinical advisers. Last reviewed October 2022.

Sources

Page reference: 587383

Review key: HITGN-587383