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Trigeminal neuralgia

​Trigeminal neuralgia is a severe pain of the face caused by pressure on nerves.

The pain may be a symptom of some other underlying medical condition.

The Neurosciences team of Marshfield Clinic treats all diseases and conditions of the brain, spinal chord and the networks of sensory nerve cells called neurons.

What Is Trigeminal Neuralgia?

Trigeminal neuralgia is a type of nerve pain that affects your face.

You may feel an intense burst of pain in part of your face, usually 1 side of the jaw or cheek. The pain may be burning or sharp and so severe that you can’t eat or drink.

A flare-up begins with tingling or numbness in the area. Then pain starts to come and go, often in bursts that last anywhere from a few seconds to 2 minutes.

During a flare of the condition, these bursts of pain may become more and more frequent until the pain almost never stops. Although the intensity of the pain can make it hard to get through your day, it’s not life-threatening.

This chronic pain condition can flare up for a few weeks or months. Then the pain disappears for a while, sometimes years.

Facts about trigeminal neuralgia

This pain condition happens most often in people older than 50, though younger people can also experience it. Trigeminal neuralgia is more common in women than men. 

Pressure on your cheek, like from a razor when shaving or from your fingers when applying makeup, can trigger the pain. Brushing your teeth, standing in the wind, washing your face, eating, drinking, and even talking also may cause it.

Experts think that a blood vessel pressing against the trigeminal nerve triggers the pain. Sometimes multiple sclerosis or, rarely, a tumor causes the pain.

Symptoms

People with trigeminal neuralgia may experience these symptoms:

  • Tingling or numbness in the cheek or jaw

  • Dull aching in the cheek or jaw

  • Flashes of severe pain in the cheek or jaw

  • Anxiety from the thought of the pain returning

Diagnosis

To diagnose trigeminal neuralgia, your healthcare provider will typically take your medical history and do a physical exam. Giving your healthcare provider details of the pain, like where and when it happens, may help with making a diagnosis. Imaging tests might be used to try to rule out other causes of pain.

Treatment

Most common over-the-counter and prescription pain medicines don’t work for people with this condition. Treatment for trigeminal neuralgia may include:

  • Anticonvulsant medicine

  • Tricyclic antidepressants

  • Surgery, if medicine has failed

  • Acupuncture

  • Biofeedback

  • Stereotactic radiosurgery

  • Percutaneous balloon rhizotomy

  • Radiofrequency ablation

Prevention

Experts don’t know how to prevent trigeminal neuralgia. You may learn to avoid certain activities that seem to trigger the pain more than others.

Managing trigeminal neuralgia

Although not fatal, the pain and anticipation of the pain can interfere with your life. Working closely with your healthcare provider will help you find the best pain management approaches for you.

Alternative therapies, like acupuncture and biofeedback have also been shown to help.

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 Multiple Sclerosis

How Much Do You Know About Multiple Sclerosis?

Multiple sclerosis (MS) is a disease of the central nervous system, the brain, and spinal cord. Its symptoms can range from benign to severe. Find out more about this mysterious illness by taking this quiz, based on information from the National Institute of Neurological Disorders and Stroke (NINDS).

1. Although exact numbers are not available, approximately how many people in the United States have MS?
2. MS affects the central nervous system (CNS). Which part of the CNS is affected?
3. Which age group is MS most likely to strike?
4. Although the exact cause of MS is not yet known, which factor may play a role?
5. How does the disease usually progress?
6. A woman with MS who wants to have children should be aware that her disease may affect her pregnancy in what way?
7. What are some of the symptoms of MS?
8. If symptoms and a physical exam suggest a diagnosis of MS, how does a doctor confirm it?
9. Which therapy is often recommended for treating slowly progressing MS?
10. Which of these so-called therapies is NOT recommended for MS?