What is Trigeminal neuralgia?

Trigeminal neuralgia

What is trigeminal neuralgia?

Trigeminal neuralgia is a rare condition that causes attacks of bad pain in your face. Although it's difficult to live with, it's not dangerous. There are lots of treatments that you may find helpful.

If you have trigeminal neuralgia, you get sudden, short attacks of bad pain in your face. They usually affect just one side of your face, and they keep coming back. Trigeminal neuralgia is sometimes called tic douloureux.

Source:
Merskey H, Bogduk N (editors).
Classification of chronic pain.
2nd edition. International Association for the Study of Pain, Seattle, U.S.A.; 1994.

¹ "Tic douloureux" just means "painful tic" in French.

Neuralgia means pain coming from a nerve. In trigeminal neuralgia, the pain comes from the trigeminal nerve. That's one of the largest nerves in your head. It carries feelings of touch, pain, pressure and temperature from your face to your brain.

Source:
National Institute of Neurological Disorders and Stroke.
NINDS trigeminal neuralgia information page.
February 2009. Available at http://www.ninds.nih.gov/disorders/trigeminal_neuralgia (accessed on 6 March 2009).

It also controls the muscles you use for chewing.

Source:
Gray H.
Anatomy of the human body, 1918.
Available at http://www.bartleby.com/107/200.html (accessed on 10 March 2009).

The trigeminal nerve has three branches (also called divisions). They carry feeling to your brain from these three areas:

Source:
Mayo Clinic.
Trigeminal neuralgia.
April 2008. Available at http://www.mayoclinic.com/health/trigeminal-neuralgia/DS00446 (accessed on 10 March 2009).

⁴

Your eye, upper eyelid and forehead (doctors call this the ophthalmic division of the nerve)
Your cheek, lower eyelid, nostril, upper lip and upper gum (the maxillary division)
Your jaw, lower lip, lower gum and some of the muscles used for chewing (the mandibular division).

You can feel the pain of trigeminal neuralgia in any or all of these areas.

Source:
Katusic S, Beard CM, Bergstralh E, et al.
Incidence and clinical features of trigeminal neuralgia, Rochester, Minnesota, 1945-84.
Annals of Neurology. 1990; 27: 89-95.

⁵

About two-thirds of people with trigeminal neuralgia feel pain in the cheek area.
About half feel it in the jaw area.
About a fifth feel it in both cheek and jaw areas.
Pain around the eye is less common. Less than a fifth of people feel pain in this area.
About 1 in 100 people with trigeminal neuralgia get pain in all three areas.

You are more likely to get trigeminal neuralgia if you:

Source:
Katusic S, Beard CM, Bergstralh E, et al.
Incidence and clinical features of trigeminal neuralgia, Rochester, Minnesota, 1945-84.
Annals of Neurology. 1990; 27: 89-95.

⁵

Are a woman
Are over age 50
Have

high blood pressure
Your blood pressure is considered to be high when it is above the accepted normal range. The usual limit for normal blood pressure is 140/90. If either the first (systolic) number is above 140 or the lower (diastolic) number is above 90, a person is considered to have high blood pressure. Doctors sometimes call high blood pressure "hypertension."

high blood pressure.

We don't know exactly what causes trigeminal neuralgia. Some doctors think the pain is caused by blood vessels pressing on the root of the trigeminal nerve, at the base of the brain. Doctors think this may be the cause for most people with trigeminal neuralgia.

Source:
Mayo Clinic.
Trigeminal neuralgia.
April 2008. Available at http://www.mayoclinic.com/health/trigeminal-neuralgia/DS00446 (accessed on 10 March 2009).

⁴

There are some other things that we know can cause trigeminal neuralgia. But they are found in only a minority of people with the condition. They include:

Source:
Mayo Clinic.
Trigeminal neuralgia.
April 2008. Available at http://www.mayoclinic.com/health/trigeminal-neuralgia/DS00446 (accessed on 10 March 2009).

⁴

A tumor pressing on the nerve. This is almost always a non-cancerous (benign) tumor
A

stroke
You have a stroke when the blood supply to a part of your brain is cut off. This damages your brain and can cause symptoms like weakness or numbness on one side of your body. You may also find it hard to speak if you've had a stroke.

stroke. If you have a stroke, you might have a blood clot affecting the lower part of your brain, where the trigeminal nerve enters your central nervous system
multiple sclerosis
Multiple sclerosis, or MS for short, is a disease that involves damage to the walls of nerves. No one knows for sure what causes it. If you have multiple sclerosis, you may lose feeling in certain parts of your body. You may also have trouble with your vision or controlling your movements.

Multiple sclerosis. This condition affects the nervous system and can damage the trigeminal nerve. But it's very unlikely that facial pain would be the first symptom you'd notice if you had multiple sclerosis. If you have trigeminal neuralgia, but no other symptoms, you are not likely to have multiple sclerosis.

Sources for the information on this page:

Merskey H, Bogduk N (editors).Classification of chronic pain.2nd edition. International Association for the Study of Pain, Seattle, U.S.A.; 1994.

National Institute of Neurological Disorders and Stroke.NINDS trigeminal neuralgia information page.February 2009. Available at http://www.ninds.nih.gov/disorders/trigeminal_neuralgia (accessed on 6 March 2009).

Gray H.Anatomy of the human body, 1918.Available at http://www.bartleby.com/107/200.html (accessed on 10 March 2009).

Mayo Clinic.Trigeminal neuralgia.April 2008. Available at http://www.mayoclinic.com/health/trigeminal-neuralgia/DS00446 (accessed on 10 March 2009).

Katusic S, Beard CM, Bergstralh E, et al.Incidence and clinical features of trigeminal neuralgia, Rochester, Minnesota, 1945-84.Annals of Neurology. 1990; 27: 89-95.

This information was last updated on Apr 09, 2009

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