WHAT IS TRIGEMINAL NEURALGIA?
The trigeminal nerve is the largest nerve in the head and is responsible for sensation in the face and motor functions such as biting and chewing.1 It has three branches that send signals from the upper, middle and lower portions of the face, as well as the oral cavity, to the brain.1
Neuralgia is pain that follows the path of a nerve or nerves.1
Trigeminal neuralgia (TN) is long-term (chronic) pain that is associated with the trigeminal nerve and usually caused by damage or trauma.1 Because it concerns pain associated with nerves, TN is a type of neuropathic pain.
WHAT CAUSES TRIGEMINAL NEURALGIA?
There are a number of possible causes of TN:
- Compression of the trigeminal nerve by blood vessels can cause damage to the protective coating around the nerve.1
- Injury to the trigeminal nerve, such as facial trauma from a car accident, a stroke or surgery, may cause neuropathic facial pain.1
TN is found in about 2–6% of people with multiple sclerosis, a condition that affects nerves.1,3 However, in some cases, the cause of TN cannot be identified, this is known as idiopathic TN.2
The damaged nerve cannot correctly transmit signals to the brain. Instead, these signals become exaggerated, causing chronic pain that may persist for months or even years. This can lead to pain attacks at the slightest stimulation of any area served by the nerve as well as hinder the nerve's ability to shut off the pain signals after the stimulation ends.1,2
WHAT ARE THE TYPICAL SYMPTOMS OF TRIGEMINAL NEURALGIA?
TN can be characterised by episodes of intense facial pain that is usually located on one side of the face at a time, although occasionally it is located on both sides of the face. These episodes last from a few seconds to several minutes or hours. It may repeat various times throughout the day – episodes of pain rarely occur at night, when a person is sleeping.1
For many people, the pain is spontaneous, without any stimulation. The attacks are said to feel like ‘stabbing electric shocks’, ‘aching’ or ‘burning pain’. The intense flashes of pain can also be triggered by vibration or contact with the cheek (e.g. when shaving, washing the face or applying make-up), brushing teeth, eating and drinking. Sometimes, even wind on the affected sensitive skin can cause an episode.1,2
HOW IS TRIGEMINAL NEURALGIA DIAGNOSED?
The diagnosis of TN is usually based on a person’s medical history and the description of their symptoms, along with physical and neurological examinations. Healthcare professionals often find it challenging to obtain the correct diagnosis as the symptoms can be similar to other neuropathic pain conditions, such as post-herpetic neuralgia.1 Therefore, it is important that people describe their symptoms in as much detail as possible to their doctor.
1. National Institute of Neurological Disorders and Stroke. Trigeminal neuralgia fact sheet. 2020. Available at: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Trigeminal-Neuralgia-Fact-Sheet. Accessed June 2021.
2. Maarbjerg S et al. Cephalalgia 2017;37:648–57.
3. Foley PL et al. Pain 2013;154:632–42.