Drexel University College of Medicine

Diseases and Conditions

Trigeminal neuralgia

Definition

Trigeminal neuralgia is very painful swelling (inflammation) of the nerve (trigeminal nerve) that delivers feeling to the face and "surface" of the eye.

Alternative Names

Causes, incidence, and risk factors

Trigeminal neuralgia causes severe, short-lasting (only a few seconds) facial pain on the side of the affected nerve. The condition usually affects older adults.

Often, no cause can be found. However, areas of brain swelling or abnormal blood vessels (arteriovenous malformations) can cause it.

Painful trigeminal neuralgia attacks may occur after lightly touching areas of the face that are along the fifth skull (cranial) nerve.

Symptoms

• Very painful, sharp electric-like spasms that last a few seconds or minutes
• Pain is usually only on one side of the face, often around the eye, cheek, and lower part of the face
• Pain may be triggered by touch or sounds
• Pain occurs while:
  • Brushing teeth
  • Chewing
  • Drinking
  • Eating
  • Shaving

Signs and tests

Magnetic resonance imaging (MRI) and blood tests may help rule out other conditions.

Treatment

Certain medicines can help reduce pain and the rate of attacks. These may include:

• Anti-epilepsy drugs (carbamazepine, gabapentin, phenytoin)
• Migraine medicines (sumatriptan)
• Tricyclic antidepressants (amitriptyline, nortriptyline, or carbamazepine)

Some patients may need surgery.

References

Kanai A, Saito M, Hoka S. Subcutaneous sumatriptan for refractory trigeminal neuralgia. Headache. 2006;46(4):577-582.

Goetz CG, ed. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: WB Saunders; 2007.

Physician Reference

International Classification of Diseases, 9^th Revision (ICD9)

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only - they do not constitute endorsements of those other sites. Copyright 2009 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.