Trigeminal neuralgia overview

Facial pain affecting the trigeminal nerve

The trigeminal or fifth cranial nerve originates from the brain stem and runs toward the structures of the face and head to supply sensation to the skin and other structures. The trigeminal nerve has 3 divisions:

  1. the ophthalmic division supplies sensation to the upper face,
  2. the maxillary division supplies the mid-face and
  3. the mandibular division supplies the lower face.

Neuralgia refers to intense pain within the distribution of a specific nerve, so trigeminal neuralgia refers to pain within the territory of the trigeminal nerve.

Trigeminal Neuralgia (or simply ‘TN’) is understood to affect 0.1-0.2% of the population and seems to particularly affect women and people over 50 years of age. Rather than improve, in most cases the condition gets worse over time. It is considered a chronic pain condition.

View Common Causes Contact Us

Common causes of trigeminal neuralgia

What can affect the trigeminal nerve?

The direct cause of trigeminal neuralgia is some form of dysfunction in the nerve, often caused by an artery or vein near the base of the brain putting pressure on the nerve. It may also be related to the protective layer around the nerve, the ‘myelin sheath’, being damaged in some way.

Factors that are linked to trigeminal neuralgia include:

  • The ageing process
  • Multiple sclerosis
  • Brain lesion
  • Facial surgical injury
  • Other injury to the face
  • Stroke
  • B1 and B12 vitamin deficiency
  • Diabetes
  • High levels of alcohol consumption
  • A tumour putting pressure on the nerve

There are also some known ‘triggers’ which precede a painful episode. These include for example:

  • Brushing teeth
  • Chewing
  • Drinking
  • Talking
  • Smiling
  • Washing the face
  • Shaving
  • Applying makeup

Even simply touching the face or feeling air movement on the face can be a trigger.

Request An Appointment Contact Us

Trigeminal neuralgia symptoms

How trigeminal nerve pain can present

The primary symptom of trigeminal neuralgia is an intense shooting, stabbing pain affecting one or more parts of the face supplied by the nerve, the cheeks, jaw, lips, gums and teeth particularly, and in some cases the scalp, forehead or eyes.

Trigeminal neuralgia generally only affects one side of the face at any one time.

Shooting or stabbing pain

Intense pain affecting one or more areas supplied by the trigeminal nerve.

Short pain episodes

Episodes may last from a few seconds to several minutes.

Repeated attacks

Multiple episodes may continue over days, weeks or, in severe cases, months.

Periods without pain

Symptoms may disappear for long periods before returning.

Aching or burning sensations

Some episodes may be preceded by a general ache or burning feeling.

Trigeminal neuralgia tests and diagnosis

How trigeminal neuralgia is assessed

The first step in the diagnosis of trigeminal neuralgia is a review of symptoms and medical history. Certain tests, such as blood tests, may be recommended to check whether any known risk factors are present.

Other tests that may be recommended include a nerve conduction study and CT and/or MRI scan.

View All Treatments Contact Us

Ready to take the next step?

  • Comprehensive pain assessments
  • Individual treatment planning
  • Medication review and optimisation

Request an appointment Contact our team

Melbourne Pain Group Glen Waverley Head Office Outside Photo