Trigeminal neuralgia is often described as one of the most painful conditions known. It causes sudden attacks of stabbing or electric-shock-like pain on one side of the face, often triggered by everyday things like brushing teeth.
Imagine bracing yourself every time you brush your teeth or feel a breeze on your cheek, because it might set off a jolt of pain so intense you freeze. You saw a dentist twice, but nothing was wrong with your teeth. A neurologist finally names the problem, and medication brings the attacks under control.
Symptoms
- Sudden, severe, stabbing or electric-shock pain
- Usually on one side of the face, in the cheek, jaw, teeth, gums or lips
- Attacks lasting seconds to about two minutes, sometimes in rapid bursts
- Pain-free periods that can last weeks or months
Common triggers
Light touch, washing the face, shaving, putting on make-up, brushing teeth, eating, drinking, talking, smiling, or even a cool breeze.
What causes it?
It’s often caused by a blood vessel pressing on the trigeminal nerve near the brain. It’s more common over age 50 and in women. Less often it’s linked to multiple sclerosis or, rarely, a tumour, so an MRI scan is commonly done.
But can it be treated?
Yes. Ordinary painkillers don’t work well, but anticonvulsant medicines such as carbamazepine help most people. They need monitoring with blood tests and dose adjustments. If medicines don’t work or cause too many side effects, surgical options include microvascular decompression or procedures that damage the nerve on purpose to stop pain signals.
Living with the fear of attacks can affect mood and eating. Support groups and talking to your care team about this matter just as much as pain control.
Your next step: If you’re getting sudden facial pain attacks, keep a log of when they happen and what triggers them, and take it to your doctor.
Sources: US National Institute of Neurological Disorders and Stroke, NHS (Trigeminal neuralgia), Mayo Clinic, Facial Pain Association.
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