Trigeminal neuralgia is a nerve disorder that causes a stabbing or electric-shock-like pain in parts of the face. The pain lasts a few seconds to a few minutes, and usually on only one side of the face. It can also cause muscle spasms in the face the same time as the pain. The pain may result from a blood vessel pressing against the trigeminal nerve (the nerve that carries pain, feeling, and other sensations from the brain to the skin of the face), as a complication of multiple sclerosis, or due to compression of the nerve by a
This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.
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Treatment options include medicines, surgery, and complementary approaches.
Anticonvulsant medicines, which are used to block nerve firing, are generally effective in treating trigeminal neuralgia. These drugs include carbamazepine, oxcarbazepine, topiramate, clonazepam, phenytoin, lamotrigine, and valproic acid. Gabapentin or baclofen can be used as a second drug to treat trigeminal neuralgia and may be given in combination with other anticonvulsants.
Tricyclic antidepressants such as amitriptyline or nortriptyline are used to treat pain described as constant, burning, or aching. Typical analgesics and opioids are not usually helpful in treating the sharp, recurring pain caused by trigeminal neuralgia. If medication fails to relieve pain or produces intolerable side effects, surgical treatment may be recommended.
Several neurosurgical procedures are available to treat trigeminal neuralgia. The choice among the various types depends on the nature of the pain, the patient's preference, physical well-being, general health, previous surgeries, presence of multiple sclerosis, and area of trigeminal nerve involvement. Some procedures are done on an outpatient basis, while others may involve a more complex operation that is performed under general anesthesia. Some degree of facial numbness is expected after most of these procedures, and trigeminal neuralgia might return despite the procedure’s initial success. Depending on the procedure, other surgical risks include
A rhizotomy is a procedure in which select nerve fibers are destroyed to block pain. A rhizotomy for trigeminal neuralgia causes some degree of permanent sensory loss and facial numbness. Several forms of rhizotomy are available to treat trigeminal neuralgia:
A neurectomy, which involves cutting part of the nerve, may be performed during microvascular decompression if no vessel is found to be pressing on the trigeminal nerve.
Some patients choose to manage trigeminal neuralgia using complementary techniques. This is usually done in combination with drug treatment. For some, low-impact exercise, yoga, creative visualization, aromatherapy, or medication helps. Other options include acupuncture, biofeedback, vitamin therapy, nutritional therapy, and electrical stimulation of the nerves.
More detailed information regarding the management of trigeminal neuralgia can be found through the National Institute of Neurological Disorders and Stroke and Medscape.
If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.
If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.
You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.
Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.
Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.
These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.
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How is trigeminal neuralgia treated? What is the long-term outlook for individuals with this condition? See answer