CMMC Neuroscience Center

Trigeminal Neuralgia

Basic Information

Trigeminal neuralgia refers to a condition of painful spasms generating from the sensory nerve in the face. This nerve is called the trigeminal nerve because it has three components. Most often the pain starts in the age range from 40-70, and presents with brief, jabbing or burn-ing sensations in the mid facial region. Pain is quite severe, and requires prompt attention. The most common cause is compression of the nerve, which originates in the brainstem, by small blood vessels. Other causes include multiple sclerosis, stroke, and mass lesions. These are all much less common than the vascular compression, which is generally a benign condition.

Symptoms

• Severe, brief, jabbing pain in the face.
  
• Associated focal headache.
  
• Contact sensitivity due to swallowing, light touch, or cold temperature.
  
• Associated dental pain and difficulty chewing, with associated weight loss.

Treatment Available

• The treatment of choice is carbamazepine, which is an anticonvulsant medication.
  
• Other anticonvulsants such as gabapentin, phenytoin, and valproic acid have also been used.
  
• Muscle relaxants such as baclofen are sometimes effective.
  
• Lately surgical procedures have been developed. The most common is called a microvascular decompression. Other procedures involve burning or compressing the nerve as it emerges from the face and these are less invasive.
  
  

Research

• New surgical procedures.
  
• New medical treatments.
  
• Radiologic (x-ray) directed beams to non-invasively damage the nerve and decrease the source of pain.
  
• Underlying age-related causes.
  

Website: Trigeminal Neuralgia Association