Sharp, Electric Facial Pain? Understanding Trigeminal Neuralgia and Your Treatment Options

Each year, nearly 150,000 Americans are diagnosed with trigeminal neuralgia, or TN. This chronic disorder causes intense facial pain that can make it difficult to eat, speak, or smile, sometimes to the point where people avoid these activities altogether.

At Palm Beach Pain Institute in Delray Beach, Florida, board-certified pain management physician Marcie Merson, MD, regularly diagnoses and treats TN. Here, she explains why TN occurs and discusses typical treatment options that can ease symptoms and provide relief.

What is trigeminal neuralgia?

Trigeminal neuralgia, abbreviated as TN, is a chronic condition characterized by intense facial pain. It occurs when the trigeminal nerve, a nerve responsible for sensation in the face, is compressed, injured, or affected for unknown reasons. 

TN-related pain typically occurs on one side of the face and is often triggered by activities such as speaking, chewing, or yawning. Although anyone can experience TN, it most commonly affects people 50 and older.

TN can be best described in terms of how the pain presents:

Paroxysmal TN

Patients with this type experience periodic bursts of intense facial pain that typically last seconds or minutes. 

TN with continuous pain

This type is less intense per episode than paroxysmal TN, but symptoms occur more frequently. Because stabbing or burning sensations can persist for days or weeks, it’s often more challenging to treat.

Triggers for trigeminal neuralgia

Any activity that involves moving or touching your face can trigger a trigeminal neuralgia episode. These activities include:

• Shaving, putting on makeup, or washing your face
• Brushing your teeth, flossing, or using mouthwash
• Eating and drinking
• Talking and smiling
• Clenching your jaw or grinding your teeth
• Yawning

Sometimes, environmental factors play a role. For example, cold or windy conditions may trigger an episode. 

Doctors also categorize TN by its underlying cause:

Primary (classic) TN

This type is the most common and occurs when a blood vessel compresses the trigeminal nerve root. 

Secondary TN

This type of TN affects about 15% of patients and happens when an underlying medical condition damages the trigeminal nerve. Common causes include multiple sclerosis (MS) and tumors. 

Idiopathic TN

This type occurs when there’s no apparent cause of facial pain. 

How is trigeminal neuralgia diagnosed?

To diagnose TN, Dr. Merson reviews your health history, asks about your symptoms, including what the pain feels like and where it occurs, and examines your head and neck. She also completes neurological testing to rule out conditions that can present with similar symptoms, such as headaches, migraines, and TMJ syndrome. 

Finally, Dr. Merson orders diagnostic imaging, like a brain MRI, to pinpoint the source. This quick, painless procedure can help her identify underlying issues, like pressure from a blood vessel or tumor. After determining the type and cause of your TN, she makes custom treatment recommendations. 

Trigeminal neuralgia: Treatment options

Treatment for trigeminal neuralgia depends on the type and severity of your symptoms. Dr. Merson may suggest:

• Prescription medication, such as anticonvulsants or muscle relaxants, to reduce nerve pain
• Minimally invasive injections, such as targeted nerve blocks
• Stress management techniques to reduce facial tension
• Lifestyle changes, such as avoiding specific triggers

Many patients benefit from a combination of treatments. However, in severe cases, surgery may be necessary to relieve nerve pressure. The goal is to speak, smile, and eat comfortably by reducing the frequency of flare-ups. 

We can help you manage trigeminal neuralgia

Ongoing facial pain can significantly affect your quality of life, but you don’t have to suffer alone. Schedule an appointment today to explore potential treatment options. Book online or call our office at 561-499-7020.