What Is Trigeminal Neuralgia?
Trigeminal neuralgia (TN) is a chronic pain condition that affects the trigeminal nerve, which is responsible for facial sensation. It causes sudden, severe, electric shock-like pain typically on one side of the face—most often affecting the cheek, jaw, or around the eye.
Even mild stimulation like brushing teeth, eating, or a light breeze can trigger episodes of excruciating pain. Trigeminal neuralgia can significantly disrupt daily life but is treatable with a range of options.
Common Causes
Trigeminal neuralgia occurs when the trigeminal nerve is compressed or irritated, often by a nearby blood vessel (neurovascular compression). Other causes include:
Multiple sclerosis (MS) – Demyelination of the trigeminal nerve root
Tumors or cysts pressing on the nerve
Post-herpetic neuralgia following shingles
Facial trauma or dental procedures
Idiopathic cases (no identifiable cause)
Symptoms
Sudden, stabbing, or shock-like pain on one side of the face
Pain triggered by routine activities like talking, chewing, or washing the face
Episodes lasting from seconds to minutes, often recurring in clusters
Tingling or numbness may be present in some cases
Can progressively worsen without treatment
Non-Surgical Treatment Options
Medications
Anticonvulsants (e.g., carbamazepine, oxcarbazepine) – First-line therapy
Baclofen – Muscle relaxant that can be used adjunctively
Tricyclic antidepressants – For patients with mixed pain profiles
These medications can reduce nerve excitability and suppress painful episodes.
Lifestyle Modifications
Identifying and avoiding known triggers (e.g., cold wind, brushing teeth)
Stress management techniques to reduce flare-ups
Interventional Treatment Options
When medications become less effective or cause intolerable side effects, interventional options can provide targeted, longer-lasting relief:
Trigeminal Nerve Blocks
Injection of a local anesthetic and steroid near the trigeminal nerve branches
Used for diagnostic and short-term relief of acute flares
Sphenopalatine Ganglion Block (SPG)
Minimally invasive procedure using a small catheter inserted into the nasal passage
Can reduce facial pain by modulating autonomic nerve signals
Radiofrequency Ablation (RFA)
Heat-based ablation of targeted nerve fibers to interrupt pain transmission
Provides longer-term relief, especially for patients with frequent attacks
Glycerol Rhizotomy or Balloon Compression
Performed under imaging guidance to selectively damage pain-conducting fibers of the trigeminal nerve
Often done by a neurosurgeon in recurrent or medication-resistant cases
Peripheral Nerve Stimulation (PNS)
Implantation of a small device to stimulate specific nerve branches
A newer option for patients with chronic, refractory facial pain
When Is Surgery Needed?
If interventional and medical therapies fail, neurosurgical procedures may be considered:
Microvascular Decompression (MVD) - A surgical procedure that relocates or removes the blood vessel compressing the trigeminal nerve. Often preferred for long-term control in younger, healthy patients.
Gamma Knife Radiosurgery - A non-invasive technique using focused radiation to damage the nerve root and reduce pain over time.
Conclusion
Trigeminal neuralgia is a uniquely painful condition, but patients today have access to a wide range of effective treatments—from medications to advanced interventional pain procedures and minimally invasive surgical options. Early diagnosis and a personalized treatment plan are essential for achieving meaningful and lasting relief.
👉 Schedule a consultation with our specialists to explore your best path toward relief.