Specialist diagnosis and management of trigeminal neuralgia in Thousand Oaks, CA — a facial nerve pain condition that causes sudden, severe, electric shock-like pain.
What Is Trigeminal Neuralgia?
Trigeminal neuralgia is a neuropathic facial pain disorder affecting the trigeminal nerve, which carries sensation from the face. It produces brief, intense, electric or stabbing pain on one side of the face. It is one of several conditions grouped under orofacial pain and requires careful diagnosis to distinguish it from dental and other facial pain.
Symptoms
- Sudden, severe, shock-like or stabbing pain, usually on one side of the face
- Pain triggered by light touch, chewing, talking, brushing teeth, or a breeze on the face
- Attacks lasting seconds to a few minutes, often in clusters
- Pain following the cheek, jaw, or area around the eye (trigeminal nerve branches)
- Periods of remission followed by recurrence
Causes
The most common cause is compression of the trigeminal nerve by a nearby blood vessel (classical trigeminal neuralgia). In some cases, an underlying condition such as multiple sclerosis or a structural lesion is identified (secondary trigeminal neuralgia), which is why imaging is an important part of evaluation.
Diagnosis
Diagnosis is based on the characteristic pattern of pain, a focused neurological examination, and criteria consistent with the International Classification of Orofacial Pain and ICHD-3. Magnetic resonance imaging (MRI) is often obtained to identify neurovascular compression and to rule out secondary causes.
Treatment
First-line treatment is medication, typically an anticonvulsant such as carbamazepine or oxcarbazepine, which reduces nerve excitability. When pain is not controlled with medication, referral for neurosurgical options such as microvascular decompression or stereotactic radiosurgery is coordinated. As an orofacial pain practice, we confirm the diagnosis, manage medical therapy, exclude dental causes, and coordinate specialist referral when needed.
