Navigate Up

Pediatric Center - A-Z Index

#
Q
Z

Print This Page

Trigeminal neuralgia

Trigeminal neuralgia is a nerve disorder that causes a stabbing or electric-shock-like pain in parts of the face.

Alternative Names

Tic douloureux

Causes, incidence, and risk factors

The pain of trigeminal neuralgia comes from the trigeminal nerve. This nerve carries the feelings of touch and pain from the face, eyes, sinuses, and mouth to the brain.

The condition usually affects adults, but it may affect anyone at any age. Trigeminal neuralgia may be part of the normal aging process.

Trigeminal neuralgia may be caused by:

  • Multiple sclerosis
  • Pressure on the trigeminal nerve from a swollen blood vessel or tumor

Often, no cause is found.

Doctors are more likely to find a cause in a person who is younger than age 40.

Symptoms

  • Very painful, sharp electric-like spasms that usually last a few seconds or minutes, but can become constant
  • Pain is usually only on one side of the face, often around the eye, cheek, and lower part of the face
  • Pain may be triggered by touch or sounds
  • Painful attacks of trigeminal neuralgia can be triggered by common, everyday activities, such as:
    • Brushing teeth
    • Chewing
    • Drinking
    • Eating
    • Lightly touching the face
    • Shaving

Signs and tests

A brain and nervous system (neurologic) examination is usually normal.

Tests that are done to look for the cause of the problem include:

Treatment

Your primary care physician, a neurologist, or a pain specialist may be involved in your care.

Certain medicines sometimes help reduce pain and the rate of attacks. These medicines include:

  • Anti-seizure drugs (carbamazepine, gabapentin, lamotrigine, phenytoin, valproate, and pregabalin)
  • Muscle relaxants (baclofen, clonazepam)
  • Tricyclic antidepressants (amitriptyline, nortriptyline, or carbamazepine)

Some patients may need surgery to relieve pressure on the nerve. Techniques include:

  • Cutting or destroying part of the trigeminal nerve
  • Destroying the trigeminal nerve with a needle or probe placed through the skin using radiofrequency ablation or an injection of glycerol
  • Electrostimulation
  • Percutaneous balloon microcompression
  • Removal of the tumor (when a tumor is the cause)
  • Stereotactic radiosurgery (Gamma knife)
  • Surgery to remove a blood vessel that is putting pressure on the trigeminal nerve (called microvascular decompression, or MVD)

Expectations (prognosis)

How well you do depends on the cause of the problem. If there is no disease causing the problem, treatment can provide at least some relief.

However, the pain may become constant and severe in some patients.

References

Digre KB. Headaches and other head pain. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier;2011:chap 405.

Zakrzewska JM, Skram H. Neurosurgical interventions for the treatment of classical trigeminal neuralgia. Cochrane Database Syst Rev. 2011 Sep 7;(9):CD007312.

Gronseth G, Cruccu G, Alksne J, Argoff C, Brainin M, Burchiel K, et al. Practice parameter: the diagnostic evaluation and treatment of trigeminal neuralgia (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the European Federation of Neurological Societies. Neurology. 2008;71:1183-1190.

Updated: 5/21/2012

Luc Jasmin, MD, PhD, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles, and Department of Anatomy at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.


©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com