What is trigeminal neuralgia?

Trigeminal neuralgia, also called tic douloureux, is a type of neuralgia, or nerve pain. It is usually felt as a sudden stabbing or shocking pain in the jaw or cheek area on one side of the face. Because of its intensity, it can be challenging to live with. However, there are treatments available that can help.

The trigeminal nerve

The nervous system involves a complex network of nerves that send impulses from different parts of the body to the brain. Trigeminal neuralgia involves one particular nerve — the trigeminal nerve, which is one of the largest nerves in the head.

Trigeminal neuralgia affects parts of the head such as the face, jaw, gums, eyes and forehead.

What are the symptoms of trigeminal neuralgia?

The main symptom of trigeminal neuralgia is a sudden pain, usually felt on one side of the jaw or cheek. The pain can be mild, especially when the condition first develops, but more often it is sharp, shooting, stabbing, burning or electric shock-like.

Attacks tend to come and go, each lasting between about 10 seconds to a few minutes. They can be present for a while, then go away for weeks or months, then come back again. People with trigeminal neuralgia might have no pain between attacks, or might have a dull ache in the face and jaw.

The pain can be triggered by talking, chewing, swallowing, eating hot or cold food or drinks, and brushing teeth. Or it can come on for no obvious reason.

People who have trigeminal neuralgia often feel quite distressed by the pain, and the way it comes and goes. They can feel down, lose weight and have trouble sleeping.

What causes trigeminal neuralgia?

Often, trigeminal neuralgia is caused by a blood vessel pressing on the trigeminal nerve. This compression damages the nerve over time, interfering with its normal functioning.

Occasionally, the condition is caused by a stroke, a tumour, or multiple sclerosis. Sometimes a cause can’t be found.

How is trigeminal neuralgia diagnosed?

To diagnose trigeminal neuralgia, a doctor might:

• ask you about your symptoms
• do a physical examination of your head and neck
• do some simple tests to check your nerves

The doctor may also suggest you have an MRI scan to help find the cause or show whether surgery is needed.

How is trigeminal neuralgia treated?

Trigeminal neuralgia can be treated in different ways depending on how bad the pain is and whether the cause is known.

The main treatment is carbamazepine, which belongs to a group of drugs known as anticonvulsants. Other medications, such as baclofen, clonazepam, gabapentin, and valproic acid, can sometimes be used. Learn more about medicines.

Sometimes surgery is an option. For example:

• if there is a blood vessel compressing the trigeminal nerve, the vessel may be removed
• part of the trigeminal nerve can be deliberately damaged or destroyed using electricity, radiation, or injections

With surgery, there is a risk of temporary or permanent numbness on the face.

Botox injections have been tried, though there is not yet good evidence of it’s effectiveness.

Resources and support

The Trigeminal Neuralgia Association Australia has more information and details of support groups for people with trigeminal neuralgia.