Debilitating facial pain may Be trigeminal neuralgia

January 16, 2014 Dean Hamilton, ARNP

All pain can be frightening, but when patients describe sharp, electric-type pain in their face, the cause may be Trigeminal Neuralgia, a treatable pain syndrome manifesting as unilateral facial pain that can be severe in intensity. The pain occurs in one or more distributions of the trigeminal nerve. The pain usually lasts for several seconds to several minutes followed by periods of being pain free. Trigeminal neuralgia pain can be triggered by sensory stimuli to the face including talking, brushing teeth, eating, and touching the face. In some cases, there is no trigger. The annual incidence of trigeminal neuralgia is approximately 4 in 100,000. The initial workup for trigeminal neuralgia may include an MRI of the brain to rule out brain tumor or MS plaques.

In many cases, trigeminal neuralgia is caused by compression of the facial nerve most commonly by the superior cerebellar artery or the anterior inferior cerebellar artery, although trigeminal neuralgia can be due to compression by a persistent permanent trigeminal artery or odioectatic basilar artery. Other causes of Trigeminal Neuralgia can include demyelinating disease (such as multiple sclerosis) and tumor. In some cases, the cause of Trigeminal Neuralgia is unknown.  

Other diseases that can cause facial pain include dental abscess, tumor, herpes zoster, or temporal arteritis (inflammation of the blood vessels).

There are several treatment options for Trigeminal Neuralgia. They can include medications such as Tegretol, Baclofen, and Gabapentin. If medication fails to improve symptoms or if medication side effects are not tolerated, additional treatment options for trigeminal neuralgia are available at Swedish Neuroscience Institute including radiosurgery and microvascular decompression. Patients experiencing symptoms should be evaluated by their physician for a treatment plan.

For more information regarding trigeminal neuralgia and treatment options, click here.

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