The main symptom of trigeminal neuralgia is sudden attacks of severe sharp shooting facial pain that last from a few seconds to about two minutes.

The pain is often described as excruciating, similar to an electric shock. The attacks can be so severe that you're unable to do anything during them.

Trigeminal neuralgia usually affects one side of the face. In rare cases it can affect both sides, although not at the same time.

The pain can be in the teeth, lower jaw, upper jaw, cheek and, less commonly, in the forehead or the eye.

You may sense an attack that's about to come on, although attacks usually start unexpectedly.

After the main severe pain has subsided, you may experience a slight ache or burning feeling. You may also have a constant throbbing, aching or burning sensation between attacks.

You may experience regular episodes of pain for days, weeks or months at a time. Sometimes the pain may disappear completely and not return for several months or years. This period is known as remission.

However, in severe cases of trigeminal neuralgia attacks may occur hundreds of times a day and there may be no periods of remission.

Symptom triggers

Attacks of trigeminal neuralgia can be triggered by certain actions or movements, such as:

  • talking
  • smiling
  • chewing
  • brushing your teeth
  • washing your face
  • a light touch
  • shaving or putting on make-up
  • swallowing
  • kissing
  • a cool breeze or air conditioning
  • head movements
  • vibrations, such as walking or a car journey

However, pain can occur spontaneously with no trigger whatsoever.

Further problems

Living with trigeminal neuralgia can be very difficult and your quality of life can be significantly affected.

You may feel like avoiding activities such as washing, shaving or eating to avoid triggering the pain, and the fear of pain may mean you avoid social activities.

However, it's important to try to live a normal life and be aware that becoming undernourished or dehydrated can make the pain far worse.

The emotional strain of living with repeated episodes of pain can lead to psychological problems, such as depression.

During periods of extreme pain some people may even consider suicide. Even when pain-free, you may live in fear of the pain returning.

When to see your GP

You should see your GP if you experience frequent or persistent facial pain, particularly if standard painkillers such as paracetamol and ibuprofen don't help and a dentist has ruled out any dental causes.

Your GP will try to identify the problem by asking about your symptoms and ruling out conditions that could be responsible for your pain.

Trigeminal neuralgia can be difficult to diagnose, so it's important to try to describe your symptoms as accurately and in as much detail as possible.

Read more about diagnosing trigeminal neuralgia.

Page last reviewed: 22/08/2016

Next review due: 22/08/2019