- The pain comes from one or more branches of the
trigeminal nerve-the major carrier of sensory information from the face to
- There are 3 branches of the trigeminal nerve: the
ophthalmic, maxillary, and mandibular. The pain of trigeminal neuralgia
occurs almost exclusively in the maxillary and mandibular divisions.
- You most commonly feel pain in the maxillary nerve,
which runs along your cheekbone, most of your nose, upper lip, and upper
teeth. Next most commonly affected is the mandibular nerve, affecting
your lower cheek, lower lip, and jaw.
- In almost all cases , pain will be restricted to one
side of your face.
- Most of the time, doctors cannot identify any disease
of the trigeminal nerve or the central nervous system.
- Trigeminal neuralgia most frequently affects women
older than 50 years. The disease occurs rarely in those younger than 30
years. Such cases are usually linked to damage from diseases of central
nervous system, for example, multiple sclerosis.
- The condition has no clear-cut cause.
- Some experts argue that the syndrome is caused by
traumatic damage to the nerve as it passes from the openings in the skull
to the muscles and tissue of the face. The damage compresses the nerve,
causing the nerve cell to shed the protective and conductive coating
- Others believe the cause stems from biochemical change
in the nerve tissue itself.
- A more recent notion is that an abnormal blood vessel
compresses the nerve as it exits from the brain itself.
- In all cases, though, an excessive burst of nervous
activity from a damaged nerve causes the painful attacks.
- A defining feature of trigeminal neuralgia is the
trigger zone-a small area in the central part of the face, usually on a
cheek, nose, or lip, that, when stimulated, triggers a typical burst of
- A light touch or vibration is the most effective
- Because of this, many common daily activities trigger
- Washing your face, brushing your teeth, shaving, or
- Common sensations such as having wind hit your face
- Eating and chewing
- Many people avoid food and drink rather than experience
the severe pain.
- These people risk weight loss and dehydration, a
leading cause of hospitalization in this group.
- People frequently require hospitalization for rapid
pain control when their trigeminal neuralgia becomes unmanageable at
- Between attacks, most people remain relatively
pain-free. A subgroup, however, experience a dull ache between attacks,
suggesting physical compression of the affected nerve, either by a blood
vessel or some other structure.