Trigeminal neuralgia

What is trigeminal neuralgia?

Trigeminal neuralgia is a chronic pain condition that causes episodes of severe facial pain, often triggered by everyday activities such as eating, talking or brushing your teeth.

Quick facts about trigeminal neuralgia

Trigeminal neuralgia most commonly develops after the age of 50, more often in women than men
Only 0.3% of people are estimated to experience trigeminal neuralgia during their lifetime
Around 70% of people experience pain affecting the areas around the cheek and jaw

Types of trigeminal neuralgia

Trigeminal neuralgia can have different underlying causes. Identifying the type can help guide decisions about how symptoms are managed.

Classical trigeminal neuralgia
Classical trigeminal neuralgia is usually caused by a blood vessel pressing against the trigeminal nerve where it enters the brainstem. This pressure can affect the protective covering of the nerve and interfere with the way pain signals are transmitted.
Secondary trigeminal neuralgia
Secondary trigeminal neuralgia occurs when another condition affects the trigeminal nerve. Causes can include multiple sclerosis or, less commonly, a tumour or another condition that puts pressure on or damages the nerve.
Idiopathic trigeminal neuralgia
Sometimes, no clear cause of trigeminal neuralgia can be identified. This is known as idiopathic trigeminal neuralgia.

Signs and symptoms of trigeminal neuralgia

Trigeminal neuralgia causes facial pain that can be sudden and intense. Symptoms vary between people and may change over time.

The pain typically affects one side of the face, often around the cheek, jaw, teeth, gums or lips. Less commonly, it may affect the forehead or eye area.

Trigeminal neuralgia symptoms may include:

Sudden, severe facial pain - Sharp, shooting or electric shock-like pain that can last from a few seconds to a couple of minutes.

Pain on one side of the face - Pain usually occurs on one side and follows one or more branches of the trigeminal nerve.

Pain triggered by everyday activities - Eating, drinking, talking, smiling, shaving, washing your face or brushing your teeth may trigger pain.

Repeated episodes of pain - Episodes can occur several times a day and may become more frequent or intense over time.

Periods without pain - Some people experience periods where symptoms improve or disappear before returning.

Ongoing facial pain - Some people may experience continuous aching, burning or throbbing pain alongside episodes of more intense pain.

If you’re experiencing new or unexplained facial pain, speak with your GP or healthcare professional. Several conditions can cause facial pain, so an accurate diagnosis is important.

How is trigeminal neuralgia diagnosed?

There is no single test used to diagnose trigeminal neuralgia. Your doctor will usually ask about your symptoms, including where you experience pain, what it feels like, how long it lasts and what triggers it.

A neurological examination may be used to assess sensation in different areas of your face and help determine which parts of the trigeminal nerve may be affected.

You may also have an MRI scan to help identify possible causes, such as a blood vessel pressing against the trigeminal nerve, and rule out other conditions.

Treatment for trigeminal neuralgia

There are several ways trigeminal neuralgia can be managed, including medication, surgical procedures and Gamma Knife radiosurgery.

Discover treatment options

Frequently asked questions

Several conditions can cause facial pain that may be mistaken for trigeminal neuralgia. These can include dental problems, temporomandibular joint (TMJ) disorders, migraine and other headache disorders, sinus conditions and other types of nerve pain.
Because facial pain can have many different causes, it’s important to speak with a healthcare professional for an accurate diagnosis.
Trigeminal neuralgia is often caused by a blood vessel pressing against the trigeminal nerve near the brainstem. It can also be associated with conditions such as multiple sclerosis. In some cases, no clear cause can be identified.
An MRI can form an important part of investigating trigeminal neuralgia, but the diagnosis is primarily based on your symptoms and clinical assessment.
MRI imaging can help doctors look for possible causes of your facial pain, such as a blood vessel pressing against the trigeminal nerve, multiple sclerosis or, less commonly, a tumour or other structural change.
There is no single treatment that can guarantee a permanent cure for trigeminal neuralgia. However, treatments can provide significant pain relief for many people, and some procedures can provide long periods with little or no pain.
The most appropriate treatment will depend on factors including the cause of trigeminal neuralgia, symptoms, general health and previous treatments.
Treatment for trigeminal neuralgia continues to evolve, with options ranging from medications to surgical and non-invasive procedures.
Stereotactic radiosurgery, including Gamma Knife radiosurgery, is one treatment option that uses precisely targeted radiation to treat the trigeminal nerve without an incision. Your specialist can discuss the available treatments, and which may be appropriate for you.
Botulinum toxin (Botox) injections may help reduce pain for some people with trigeminal neuralgia, particularly when other treatments have not provided adequate relief. Research into its use for trigeminal neuralgia is ongoing, and it’s not usually considered a first-line treatment.
Speak with your specialist about whether it’s appropriate for your circumstances.
Massage is not an established treatment for trigeminal neuralgia. Because light touch or pressure to the face can trigger pain for some people, facial massage may also make symptoms worse.
If you are considering massage or another complementary therapy, speak with your healthcare team about whether it’s appropriate for you.
Trigeminal neuralgia is generally a long-term condition, although symptoms can come and go. Some people experience periods of remission where they have little or no pain before symptoms return.
Triggers vary between people but can include touching your face, eating, drinking, talking, smiling, shaving, washing your face or brushing your teeth. For some people, even a light breeze on the face can trigger pain.
Depending on your symptoms and treatment needs, your care may involve healthcare professionals such as a GP, neurologist, neurosurgeon, pain specialist or radiation oncologist.

Helpful resources

Gamma Knife radiosurgery

Gamma Knife radiosurgery is a highly specialised type of radiotherapy used to treat certain complex conditions in the brain and at the base of the skull.

Learn about Gamma Knife

Treatment for trigeminal neuralgia

Explore treatment options

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