Trigeminal Neuralgia (TN) is a pain condition usually caused by pressure on the brain nerve (cranial nerve) that gives feeling to the side of the face. Signals travelling through this trigeminal nerve cause debilitating and life-altering shock-like facial pain that lasts from seconds to hours. Initial episodes may be mild, but can worsen over time if left untreated.
Trigeminal Neuralgia Symptoms
Pain from TN may result in one or more of the following patterns:
Episodes of severe, shooting or jabbing pain that may feel like an electric shock
Spontaneous attacks of pain or attacks triggered by touching the face, chewing, speaking or brushing teeth
Episodes of several attacks lasting days, weeks, or rarely months
Constant aching, burning feeling that may occur before it evolves into the spasm-like pain of TN
Pain in areas supplied by the trigeminal nerve, namely the cheek, jaw, teeth, gums, lips, or less often the eye and forehead
Pain triggered by facial contact or activity (such as shaving, washing the face, applying makeup, brushing teeth, eating, drinking and talking)
Pain almost invariably affecting only one side of the face
What causes Trigeminal Neuralgia?
The most common cause of TN is contact between a healthy blood vessel (artery or vein) and the trigeminal nerve. The pressure causes it to malfunction and send signals to the face that are perceived as pain. Other rare causes of TN include pressure of a benign tumor on the nerve or damage to the nerve in patients with multiple sclerosis (MS).
About 150,000 new cases of trigeminal neuralgia are diagnosed each year and is most common in people over the age of 50. TN is more commonly diagnosed in women than in men. Brigham and Women’s Hospital offers the only multimodality team in New England that includes medical management, radiosurgery, microvascular decompression, and radiofrequency lesioning.
How is Trigeminal Neuralgia diagnosed?
TN is typically diagnosed by the description of symptoms by the patient. Other rare causes can be ruled out through brain imaging.
How can Trigeminal Neuralgia be treated?
Treatment for TN starts with medication but can progress to surgical intervention if the improvement from medication stops, or if the patient experiences unpleasant side effects. The common types of surgery include microvascular decompression (MVD), radiofrequency lesion (RFL), and radiosurgery (gamma knife or LINAC-based).
To schedule an appointment with a physician in the Neurosurgery Pain Service please contact our Patient Coordinator at: (617) 732-6600.
If you are a physician seeking to refer a patient to the Neurosurgery Pain Service, please call (617) 732-6600 or you can access our physicians’ office phone numbers here. To contact one of our physicians with a question, patient referral or second opinion, you may also email: BWHNeurosurgery@partners.org.