Trigeminal neuralgia (TN) is a chronic pain condition caused by the dysfunction of the trigeminal nerve, a sensory nerve that sends signals to the brain from large areas of the face and mouth. This disorder is typically characterized by episodes of severe, sharp burning or shock-like pains on one side of the face (primary TN or TN1), or less frequently, by continuous aching facial pain (TN2). In the United States, around 150 thousand people are diagnosed with trigeminal neuralgia every year, and it is a common type of neuropathic pain. TN is also commonly called tic douloureux, Fothergill’s disease or trifacial neuralgia.
While TN is not life threatening, it does have major impacts on patients’ quality of life. This disorder often forces patients to forgo usual activities due to high pain levels or to avoid triggering an episode. If you or a loved one are suffering from facial pain related to trigeminal neuralgia, you can trust our team of experts at Northeast Georgia Physicians Group (NGPG) Neurology to provide you with quality and compassionate care.
Symptoms of trigeminal neuralgia
The primary symptom of trigeminal neuralgia is pain localized to one side of the face, which can manifest in a few different ways. The two types of trigeminal neuralgia (TN1 and TN2) present different sets of symptoms, and it rare cases they can be experienced together. In both types of TN, flushing can occur on the affected side of the face.
TN1 Symptoms
Trigeminal neuralgia 1 is the more common disorder type. Those with TN1 usually experience short, intense episodes of pain in a small area on one side of the face repeatedly over time. Some common symptoms of TN1 may include:
- Repeated episodes of intense, sharp, electric shock-like pain on one side of the face.
- Episodes can last anywhere from a few seconds to two minutes or come in clusters lasting up to two hours.
- Episodes may increase in frequency and severity over time.
- Episodes can occur without a trigger, but are often brought on by movement of or contact with the affected area, such as talking or brushing teeth.
- Pain is severe and can be physically and mentally incapacitating.
TN2 Symptoms
Trigeminal neuralgia 2 is characterized by more frequent and continuous pain, which occurs in a wider area of the face. Some common symptoms of TN2 may include:
- Constant, dull aching or burning sensation on a large area of the face.
- Stabbing sensation along with a constant aching to the affected area.
- Difficulty managing symptoms with pain medications.
- Muscle spasms in the face.
What causes trigeminal neuralgia?
In most cases trigeminal neuralgia is caused by the compression of the trigeminal nerve by a blood vessel. Located near the brain stem, the trigeminal nerve provides movement and sensory information for different parts of your head and face. When abnormal pressure or damage is done to this nerve, it can cause severe pain to the face and head. Causes for trigeminal neuralgia can vary on a case-by-case basis, so getting seen by a neurologist is important to determine why you may be experiencing TN pain. Some common causes of trigeminal neuralgia are:
- Compression by a blood vessel
- Compression by a tumor
- Traumatic injury to the trigeminal nerve
- Conditions like multiple sclerosis (MS)
- Stroke
- Dental issues
How is trigeminal neuralgia diagnosed?
Trigeminal neuralgia is diagnosed based on the symptoms reported to your doctors along with in-office physical and neurological exams. Because there is no exact test to determine if you have TN and what type, your physician will likely make their diagnosis based on your symptoms and a few different tests such as:
- Reflex and muscle strength tests in the face
- Magnetic resonance imaging (MRI) of the brain and neck
- Blood tests to rule out other conditions that may be causing your pain
- Examination of the head and neck
Getting seen by a healthcare professional is important to receive an accurate diagnosis and appropriate treatment for trigeminal neuralgia.
How is trigeminal neuralgia treated?
Once you receive a diagnosis of trigeminal neuralgia, there are several treatment options available to resolve your pain. Based on your diagnosis and symptoms, your doctor may recommend treating the condition with medications, surgically or a combination of the two. Some therapies for pain management can also help ease the discomfort caused by TN.
Medications
Medication is typically the first course of treatment attempted for trigeminal neuralgia. Some medications used to control neuropathic pain caused by TN include:
- Anti-convulsant or anti-seizure medications
- Muscle relaxants
- Some tricyclic antidepressants
- Topical numbing creams
Surgical Treatments
Surgical treatments for TN either seek to alleviate pressure on the trigeminal nerve or lesion the nerve to disrupt its transmission of pain signals. There are several options available, depending on the cause of the TN pain. Some surgical treatments include:
- Microvascular decompression
Surgical treatment involving the removal of blood vessels that are compressing the trigeminal nerve. - Percutaneous stereotactic rhizotomy (PSR)
A minimally invasive surgical treatment option involving the use of a needle to dismantle part of the trigeminal nerve. - Radiosurgery
Procedure that uses beams of radiation to target and eliminate the part of the trigeminal nerve that is causing pain.
Surgical treatment for TN is typically recommended for patients with severe pain that cannot control their symptoms with medication. NGPG Neurology partners with board-certified neurosurgeons who specialize in tailoring surgical treatment plans for patients suffering from trigeminal neuralgia pain.
Choose NGPG for Trigeminal Neuralgia treatment
At NGPG Neurology our trusted team of neurologists, neurosurgeons, neurointerventional surgeons, neuropsychiatrists and other specialists provide patients of North Georgia with up-to-date treatments and high-quality care. Our providers are equipped to diagnose and treat trigeminal neuralgia, offering exciting new advancements in surgical treatment.
If you or a loved one are struggling with pain you suspect is related to trigeminal neuralgia, trust our experts at NGPG Neurology to provide both superior care and access to a wide variety of treatments.