Chronic Facial Pain: Could it be Trigeminal Neuralgia?

Trigeminal neuralgia (TN) is a common cause of facial pain. It impacts the nerve network that delivers sensory information from the face to the brain. Often episodic, TN can be triggered by eating, washing your face, or even the sensation of a breeze on your face. 

Treatment is sometimes challenging. However, our team at Coast Neurosurgical Associates in Long Beach, California, often offers surgical approaches when drug therapies don’t work.  

Today, we’ll look at how to recognize the signs and triggers of TN, as well as some of the approaches to treating this incurable nerve disorder. 

Signs and symptoms of trigeminal neuralgia

Sometimes, you can identify TN by the pattern of its symptoms. The trigeminal nerve has three branches on both the left and right sides of the face. These can be affected by neuralgia. 

These branches, called quadrants, roughly cover the eyes and forehead, the middle of the face and upper palate, and the lower face and jaw. TN facial pain affects one or more of these quadrants, usually on one side of the face at a time. 

Symptoms include: 

• Sharp, electrical pain with a shooting or stabbing sensation
• Pain episodes that can be triggered by brushing teeth, chewing, speaking, touching the face, or other stimuli
• Pain that may be accompanied by facial spasms
• Pain episodes that may last from a few seconds to months, interspersed with periods of no pain
• Pain focused on one spot or spread across wider areas

Usually, TN doesn’t cause pain while you sleep, and the pain worsens over time in both frequency and intensity.

Signs of TN vary widely. The most common form of TN starts when a blood vessel presses against part of the trigeminal nerve. Secondary TN is less frequent. In this case, patients may be younger and experiencing other disorders, such as multiple sclerosis. In secondary trigeminal neuralgia (TN), the pain is more likely to occur on both sides of the face. 

Treatments for TN

Medications are the first line of treatment for TN episodes. Anticonvulsant drugs are most common because they block pain signals and reduce the frequency of pain episodes. 

Other medications that may be effective if anticonvulsants fail include baclofen and botulinum toxin type A (Botox and others). 

When medications fail to provide sufficient relief, we may recommend surgery. Approaches include vascular decompression and brain stereotactic radiosurgery, which strategically damages portions of the nerve to stop pain signal transmission. 

Contact Coast Neurosurgical Associates in Long Beach when you’re affected by trigeminal nerve pain. Call or click to book your consultation today.