Trigeminal neuralgia is a neurological condition affecting the trigeminal nerve, causing sudden, severe facial pain often described as electric shocks or stabbing sensations. Attacks are usually brief but can be intensely painful and disabling daily.
Symptoms
Trigeminal neuralgia causes brief, intense episodes of facial pain, usually affecting one side. Pain may be triggered by everyday activities such as chewing, talking, brushing teeth, shaving or light facial touch. Attacks can occur repeatedly over days or weeks, followed by pain-free periods lasting weeks, months or sometimes longer.
Causes
Trigeminal neuralgia may result from compression of the trigeminal nerve by a nearby blood vessel near the brainstem. Other causes include multiple sclerosis, tumours or structural abnormalities affecting the nerve. Some cases have no identifiable underlying cause at all.
Diagnosis
Diagnosis is based mainly on the characteristic pattern, location, duration and triggers of facial pain. MRI helps identify neurovascular compression and rule out multiple sclerosis, tumours or other structural abnormalities.
Treatment Options
Medications such as carbamazepine or oxcarbazepine are usually first-line treatments and can provide significant pain relief. If medications become ineffective or cause troublesome side effects, surgical or minimally invasive procedures may be considered.
Microvascular decompression can relieve nerve compression in suitable patients. Stereotactic radiosurgery offers a non-invasive alternative, particularly for patients who are not suitable candidates for open surgery or prefer a less invasive approach.
When to See a Specialist
Recurrent, sudden facial pain triggered by eating, talking or brushing teeth warrants specialist evaluation. Early diagnosis helps confirm the cause and determine appropriate treatment for pain.
