Trigeminal neuralgia

What is trigeminal neuralgia?

Trigeminal neuralgia is pain on one side of the face due to compression of a nerve that supplies the area. Some people say it feels like an electric shock. You might be able to tell when it’s about to start, but most of the time the pain comes on unexpectedly.

What are the symptoms of trigeminal neuralgia?

The most common symptom of trigeminal neuralgia is a sharp, intense pain on one side of the face that lasts from a few seconds to 2 minutes. The pain may also be in the jaw, cheeks, teeth, eye or forehead. Some activities that might trigger the pain may include:

• Brushing your teeth

• Shaving

• Talking

• Smiling

• Chewing

• Kissing 

• Swallowing

The pain can also be random and come on without any obvious cause.  

How common is trigeminal neuralgia?

Trigeminal neuralgia isn’t very common, affecting around 8 in 100,000 people in the UK each year. It’s more common in women than men and usually starts between ages 50 and 60. 

What causes trigeminal neuralgia?

The main cause of trigeminal neuralgia is compression of the trigeminal nerve, which provides sensation to the face. The main 2 causes of the compression are:

• A blood vessel pressing on the nerve

• Damage to the nerve itself – this is more common with conditions like multiple sclerosis

How is trigeminal neuralgia diagnosed?

There are a few ways to diagnose trigeminal neuralgia:

• A physical examination – sometimes a physical exam is all it takes for a medical professional to identify the source of the pain

• Anti-epileptic medication – you may be prescribed a short course of medicine that can reduce activation of the nerve and help the pain. If this helps, it may point to a diagnosis

• Imaging – in rare cases, an MRI may be needed to check whether the nerve is compressed

How is trigeminal neuralgia treated?

First of all, try your best to avoid common triggers of trigeminal neuralgia.

• Avoid triggers such as spicy or cold foods

• Wear a scarf to avoid being triggered by cold air

A doctor can also advise treatment for trigeminal neuralgia:

• Medication – paracetamol is not effective in treating the condition. A medication  called carbamazepine is frequently used to reduce nerve activation. If this is ineffective then you may be referred to a specialist and they might suggest alternative medication such as lamotrigine, gabapentin, pregabalin orbaclofen.

• Injection – an injection of glycerol can help reduce the activation of the trigeminal nerve to alleviate symptoms. 

• Surgery – a surgeon can make a cut behind your ear and separate a blood vessel from the nerve to reduce compression

When should I talk to a doctor?

If you have frequent facial pain and over-the-counter pain relief does not work, it is important that you make an appointment to see a GP.  

How can Livi help?

A Livi doctor will make an individual assessment based on your symptoms. You may then be given treatment or referred for specialist care.