Trigeminal Neuralgia – Excruciating Facial Pain

A young man touching his ear

Trigeminal neuralgia can cause extreme facial pain that makes it difficult for a person to go about their daily life. At Centers for Neurosurgery, Spine & Orthopedics, patients throughout northern New Jersey can receive expert care for trigeminal neuralgia and other conditions that cause facial or neck pain. Learn more about this type of nerve pain, its causes, and treatment options.

What Is Trigeminal Neuralgia?

Trigeminal neuralgia is a medical condition characterized by extreme episodes of chronic facial pain. It is caused by irritation to the trigeminal nerve, which carries sensation from the face to the brain. There are two main types of trigeminal neuralgia:

  • Type 1: Also known as typical trigeminal neuralgia, this disorder makes the patient experience episodes of intense, sharp pain that last from a few seconds to over a minute.
  • Type 2: Also known as atypical trigeminal neuralgia, this variation causes less intense pain that is more persistent and widespread throughout the face.

Trigeminal neuralgia often occurs spontaneously but is sometimes precipitated by a specific event that causes facial trauma, such as a car accident or dental surgery. It also can be brought on by compression to the trigeminal nerve, which may stem from a tumor or cyst.

While this condition is rare, it is more common among female patients than males. It also is more likely to occur in individuals over the age of 50.

The Symptoms of Trigeminal Neuralgia

Trigeminal neuralgia causes excruciating pain that some patients describe as more painful than childbirth or passing a kidney stone. Symptoms of trigeminal neuralgia can include:

  • Short, severe bursts or jolts of pain
  • Stabbing or electrical sensations
  • Numbness, burning, or tingling sensation
  • Facial spasms

Usually, trigeminal neuralgia is unilateral, meaning a patient feels pain on only one side of their face. They may feel bursts of pain in their cheek, jaw, teeth, or lips.

Unfortunately, many everyday activities trigger painful episodes of trigeminal neuralgia. These include eating, drinking, shaving, applying makeup, or brushing one’s teeth. For many patients, episodes are intermittent. They may continue for a few weeks followed by a pain-free period that can last for months.

How Trigeminal Neuralgia Is Diagnosed

Trigeminal neuralgia can be difficult to diagnose because many other conditions can cause facial pain – including ear infections, migraine headaches, and temporomandibular joint (TMJ) disorder. Typically, a primary care provider will ask the patient about their symptoms and medical history, perform a physical exam of the head and neck, and conduct a neurological exam. They may refer the patient to a neurologist or neurosurgeon for further evaluation. Most commonly it is diagnosed by a proper history and physical examination.

Imaging tests, such as an MRI, can detect whether a tumor or blood vessel is irritating the trigeminal nerve. An MRI also can check for undiagnosed multiple sclerosis, an autoimmune disease that affects the central nervous system.

Treatment Options for Trigeminal Neuralgia

Anticonvulsant medications can help some patients with trigeminal neuralgia pain management. However, because these drugs sometimes cause side effects, patients should not take them during remission periods. Another option is a nerve block, a steroid injection treatment that temporarily relieves nerve pain.

If conservative treatment options are exhausted and a patient continues to experience significant pain, they may be eligible for a procedure called trigeminal neuralgia microvascular decompression. Performed under general anesthesia, a neurosurgeon will remove a small piece of skull to access the trigeminal nerve. They will then insert a tiny Teflon plate to create a barrier between the trigeminal nerve and adjacent blood vessels. It often provides excellent results.

While this is an inpatient procedure, most patients have a short hospital stay of two or three days. According to the National Organization for Rare Disorders, a microvascular decompression procedure can provide sustained pain relief for more than 10 years.

Learn More From CNSO Today

Trigeminal neuralgia pain can be debilitating – but treatment options are available. The medical staff at Centers for Neurosurgery, Spine & Orthopedics (CNSO) has extensive experience treating nerve pain and related conditions. As New Jersey’s most comprehensive brain and spine center, CNSO provides personalized treatment plans that coordinate care across a medical staff of neurosurgeons, physiatrists, and pain management specialists. With multiple locations across northern New Jersey, patients can receive care close to home or take advantage of CNSO’s telemedicine services. To learn more about facial and neck pain treatment, contact CNSO today.


Centers for Neurosurgery Spine & Orthopedics