Imagine a pain condition so severe that it can bring you to your knees without any warning. Trigeminal neuralgia is such a pain condition, diagnosed in just over 150,000 people in the U.S. every year.

What is trigeminal neuralgia?

Trigeminal neuralgia, also referred to as tic douloureux, is a chronic pain condition that occurs when the trigeminal nerve is damaged or malfunctioning. It can lead to severe and chronic pain in the face and head.

What is the main cause of trigeminal neuralgia?

One of the major causes of trigeminal neuralgia is nerve irritation, damage, or compression.

The trigeminal nerve originates behind your ear and branches out in three directions to enervate different parts of your face:

  • Upper branch (ophthalmic) enervates the scalp, forehead, and front of the head
  • Middle branch (maxillary) involves the cheek, upper jaw, top lip, teeth and gums, and the side of the nose
  • Lower branch (mandibular) directs sensations in the lower jaw, teeth and gums, and bottom lip

Trigeminal nerves

When damage occurs to any of these parts, the malfunctioning nerve can cause severe pain in any of the areas it enervates.

There are a number of causes of nerve irritation, damage, or compression, including:

  • Pressure on the trigeminal nerve, usually by a blood vessel exiting the brain stem, which wears away the protective coating around the nerve (the myelin sheath)
  • Multiple sclerosis, a disease that causes deterioration of the myelin sheath
  • Poorly managed diabetes, a common cause of nerve damage and neuropathic pain
  • Shingles
  • Trigeminal nerve compression from a tumor
  • Arteriovenous malformation (tangled arteries and veins)
  • Injury to the trigeminal nerve (due to sinus surgery, oral surgery, stroke, or facial trauma)

What does trigeminal neuralgia pain feel like?

Trigeminal neuralgia symptoms are fairly consistent, even if their occurrence is not. The severity of each symptom varies from patient to patient, though, and symptoms may come and go at irregular intervals.

Trigeminal neuralgia symptoms are typically felt in the face, neck, shoulders, and head. You may experience:

  • Sharp, stabbing pain
  • Dull, constant aching pain
  • Sensitivity to light and sound
  • Nausea
  • Vomiting
  • Burning
  • Tingling
  • Itching

For some reason, symptoms rarely occur at night. Symptoms can last from a few seconds to several days and can completely incapacitate the sufferer. The pain may be so intense that sufferers experience momentary loss of other senses, like sight and smell.

Most sufferers experience pain in only one side of the face, but in rare cases, both sides hurt. This results in pain that is debilitating.

Pain can be triggered by the slightest breeze or touch, shaving, eating, talking, or speaking. Even drinking water can trigger pain.

Trigeminal neuralgia suicidality: diagnosis saves lives

Diagnosing this intermittent and unpredictable pain is crucial. Trigeminal neuralgia is more than just a painful irritant; it can also be deadly. The suicide rate for trigeminal neuralgia sufferers in the U.S. may be as high as 25%, nearly double the