Trigeminal neuralgia 

Introduction 

Trigeminal neuralgia is sudden, severe facial nerve pain 

Postherpetic neuralgia

This article focuses on trigeminal neuralgia, a rare type of neuralgia most commonly seen in people between 60 to 70 years of age.

Postherpetic neuralgia is a more common type of neuralgia that usually develops after a previous shingles infection.

Read more about postherpetic neuralgia.

Trigeminal neuralgia is sudden, severe facial nerve pain.

The pain in the face has been described as stabbing, piercing or like an electric shock. The pain can last from just a few seconds to two minutes each time.  

In most cases it only affects one side of the face (unilateral), more commonly the right side. Rarely, people with trigeminal neuralgia have pain on both sides of their face (bilateral).

Read more about the symptoms of trigeminal neuralgia.

In 80-90% of cases the pain is caused by pressure on the trigeminal nerve, the largest nerve inside the skull.

Read more about the trigeminal nerve and the causes of trigeminal neuralgia

Types of trigeminal neuralgia

Trigeminal neuralgia can be split into different categories depending on the type of pain. These are described below.

  • Trigeminal neuralgia type 1 (TN1) is the classic form of trigeminal neuralgia. The piercing and stabbing pain only happens at certain times and is not constant. This type of neuralgia is known as idiopathic (when no cause can be identified)
  • Trigeminal neuralgia type 2 (TN2) can be referred to as atypical (not typical) trigeminal neuralgia. Pain is more constant and involves aching, throbbing and burning sensations
  • Symptomatic trigeminal neuralgia (STN) is when pain results from an underlying cause, such as multiple sclerosis

When diagnosing trigeminal neuralgia, your doctor may test to rule out other conditions.

Who is affected?

Trigeminal neuralgia is rare. In the UK, it affects four or five people out of every 100,000 each year.

Almost twice as many women are affected as men. The condition becomes more common with age and is rare in people under 40 years of age. Trigeminal neuralgia is most commonly seen in people between 60 to 70 years of age.

Treatment for trigeminal neuralgia

Trigeminal neuralgia is a chronic (long-term) condition that often gets worse over time. There is currently no cure.

Living with trigeminal neuralgia can be difficult and can interfere with a person's quality of life. However, medication usually provides temporary relief.

If medication is not effective or causes unpleasant side effects, surgery may be recommended.  The aim of surgery is to either stop your blood vessels putting pressure on the trigeminal nerve, or to damage the nerve just enough to stop the pain signals.

Research suggests that surgery provides effective long-term pain relief and that around 70-90% of people are unlikely to experience recurring pain.

However, the chance of the pain returning will vary depending on the type of surgery used.

There are also potential side effects to consider before having surgery, such as hearing loss or facial numbness. You should discuss this with the specialist in charge of your care before deciding which treatment to have.

Read more about treating trigeminal neuralgia.

Page last reviewed: 13/07/2012

Next review due: 13/07/2014

Ratings

How helpful is this page?

Average rating

Based on 172 ratings

All ratings

Add your rating

Comments

The 13 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Ten sufferer said on 19 April 2014

I have been suffering with this awful condition for the past 16 years or so, I have been prescribed many different medications such as gabapentin, carbamazepine, amitryptiline, to name but a few!!! I typically have the tn2 pain which is a relentless pulling, burning, constant dull ache 24/7!
I feel it is a lot worse when tired which at times is completely unbarable, I've tried hot and cold compresses, and even the creams with the chilli extracts to rub on the affected area!!
The only medication which gives a temporary relief for me is solpadol or dihydrocodeine, but these only tend to give part relief for a couple of hours or so, but when you have the constant ache, you will do anything for a bit of respite from the pain!!
I can sympathise with those of you you suffering with this, lets hope there's a breakthrough treatment for it soon!!

Report this content as offensive or unsuitable

wendyrmn said on 02 March 2014

I've suffered this for 20years but its becoming more frequent now. Had acipuncture 18 months ago and worked initially with remarkable results but then had scale and polish which was a bit aggressive. TN came back but pain shifted elsewhere but no longer in scalp! Now symptoms of TMJ. Totally fed up. Never taken carbemazepine or other neuro treatments from gp. Can't afford side effects.
Researched it 4 years ago and found strong vitamin b to help (repairs nerve damage). You must check this out first though as cannot be taken with certain meds.
Try hot water bottle. If you find this irritates the pain then try cold damp face cloth out of fridge! :) when the cold starts to hurt then switch to warm compress.
When your this desperate you try anything for relief! Just sent enquiry on Prolotherapy!? Check it out...innovation from New Zealand doc..sounds promising but expect to pay private.
Good luck to all TN sufferers and hang on in there :)

Report this content as offensive or unsuitable

HannahLee said on 28 February 2014

I'm sure all TN sufferers will sympathise, but hopefully someone has advice for me: I have a cavity needing a filling top jaw on the side of my TN, exactly where the worst of my irritation occurs. What now?? Carbamazapine is currently enough for me to manage my TN2 but I'm worried that any prodding in my mouth might irritate the nerve permanently and make it harder to manage. What is worse, the injection or going 'cold turkey', extraction or filling? I can't find a single dentist able to give me advice. Please help!

Report this content as offensive or unsuitable

Prometheus2869 said on 01 February 2014

On Friday (31 Jan 14) I was told I may have TN. I have never felt pain like it. It has been getting gradually worse as the week has progressed to the point that I have an almost constant dull pain down the right side of my face and the major episodes have been excruciating and on occasion have lasted for 10 mins or more. I am currently on 'carbamazepine' (100mg) and 'tramadol' (50mg). Can't say that they are doing much at present. I have only had about 3 hours sleep in the last 4 days. My head feels like it will explode.

Report this content as offensive or unsuitable

Suzy53 said on 14 December 2013

Started with nuralgia in June 2013 had different pills seems to be getting worse awaiting for an MRI scan never experienced anything like this. Drugs just dull the pain , currently taking carbamazepine was on gabapentin 1200mg but made me docile why does me neck hurt at the back ?
Feel as I have a fat lip tingling face burning did have dental surgery and bingo this came about three weeks later was it the dentist that caused it ?
Got to see a neurologist got wait for me MRI scan
Will it ever go away ?
Need answers .

Report this content as offensive or unsuitable

Libbyalice said on 08 November 2013

I'm 18 and was diagnosed with TN a few months ago and have suffered with it since April this year. The pain has become a lot more severe over the past two months, a lot of the time resulting in tears. I can get it from twice to twelve times a day? I'm just wondering what's best for me to do and what you have all tried? I don't want to take the tablets that I have been prescribed because of the side effects. Please help! Thank you :)

Report this content as offensive or unsuitable

Katie Nizette said on 06 September 2013

Babs1972 - you need to get on the Chronic Pain listing to see a Specialist in this area. It may take time, but it's well worth the waiting. I'm a sufferer at this level and know what you are going through. I totally sympathise. Push, push and better push your GP to get seen to through this route.

Report this content as offensive or unsuitable

yokomotow said on 02 June 2013

Try using a gum shield at nite - it sure helped me

Report this content as offensive or unsuitable

sallyarmy said on 10 May 2013

ok, I am not in a lot of pain, just 2 out of 10. had MRI today, seeing consultant on Monday....symptoms; just like a bad injection in the crook of the jaw (not good at describing am I !!) for a filling affecting ear, nose, lips, and eye - feeling dry, sometimes feel 'it' in my neck! mostly on my left hand side of face... just uncomfortable... feeling anxious but they mentioned the trigeminal nerve - looked up this site... any ideas anyone? just taking paracetamol - not doing anything. just got some nurofen - hoping that will take 'it' away. reassurance needed or facts will be fine! x

Report this content as offensive or unsuitable

babs1972 said on 03 March 2013

I was diagnosed with TN2 (Atypical) a couple of years ago tried lots of different pills,none took all the pain away,
I started taking magnesium as read it can help & it did seem to....But now its back & no amount of magnesium is helping...back on nerve pills (pregabalin) ...took pills,but had to double up as prescribed dose did nothing.. ,pain has dulled, but very much still there & I feel drunk on these pills,cant walk straight... Hate this illness,it has reduced me to tears again today because the pain is so bad & constant ,,, I get the stabbing shock pains inside my head too... I know why they nick name it The suicide disease...wouldn't wish this on my worst enemy! Find a cure :(

Report this content as offensive or unsuitable

Yamazaki said on 02 February 2013

First diagnosed with TN2 ,Nov 2005.Took medication for 6 months , symptons disappeared until the end of 2011.
I am now having, assessing, Acupuncture, which, for me, does relieve symptoms for 2weeks or so.( I dont like the side effects of medication).

I have found the Trigeminal Neuralgia Association (UK) very helpful, giving me hope for the future.

Report this content as offensive or unsuitable

Just about had enough said on 22 January 2013

Had tn for 7 years now, no meds have even began to scratch the surface.

Report this content as offensive or unsuitable

Ladywriterwriter said on 17 December 2012

I have been diagnosed with this.

Report this content as offensive or unsuitable

10 sure fire ways to beat pain

Practical ways to beat pain, including relaxation tips, breathing exercises and self management courses