Trigeminal neuralgia is an inflammation of the trigeminal nerve, causing extreme pain and muscle spasms in the face. Attacks of intense, electric shock-like facial pain can occur without warning or be triggered by touching specific areas of the face. Although the exact cause of trigeminal neuralgia is not fully understood, a blood vessel is often found compressing the nerve. Several treatments can relieve the pain. Each treatment offers benefits, but each has limitations.
Neuralgia is severe pain caused by injury or damage to a nerve. The trigeminal nerve is the fifth (V) cranial nerve, which arises from the brainstem inside the skull. It divides into three branches and then exits the skull to supply feeling and movement to the face:
Ophthalmic division (V1) provides sensation to the forehead and eye.
Maxillary division (V2) provides sensation to the cheek, upper lip, and roof of the mouth.
Mandibular division (V3) provides sensation to the jaw and lower lip; it also provides movement of the muscles involved in biting, chewing, and swallowing.
When the trigeminal nerve becomes irritated, an attack of intense pain results. Also called tic douloureux because of the uncontrollable facial twitching caused by the pain, trigeminal neuralgia is serious because it interferes with many aspects of a person’s life. Typical trigeminal neuralgia involves brief instances of intense pain, like an electrical shock in one side of the face. This pain comes in repeated waves that last an hour or more. You may initially experience short, mild attacks, with periods of remission. But trigeminal neuralgia can progress, causing longer, frequent attacks of searing pain. Trigeminal neuralgia can recur in divisions of the nerve previously free of pain.