Health Care

Managing the Pain of Trigeminal Neuralgia

Senior Woman rubbing forehead in pain

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Trigeminal neuralgia is a condition that affects thousands of people in the U.S. each year. It causes facial pain so intense that it can be debilitating to live with day-to-day. Our team at the AdventHealth Neuroscience Institute can offer the support and relief you need to live life to the fullest.

Read on for the basics of trigeminal neuralgia, the most common symptoms, how to treat it, and the services we offer.

What is Trigeminal Neuralgia?

Trigeminal neuralgia has been described as "the most terrible pain known to man." While it can occur at any age and in both men and women, it is most common in women over 50. Patients suffer sudden attacks of facial pain described as intense, sharp, stabbing or like an electric shock.

The pain is usually felt in the cheekbone, nose, upper lip or teeth, but it can affect any part of the face or mouth and extend as far as the chin. Rarely, trigeminal neuralgia can affect both sides of the face. However, in most patients, it only affects one side. The stabbing pain can last from a few seconds to several minutes.

Melvin Field, MD, medical director for AdventHealth's Minimally Invasive Brain Surgery program, says, "Patients with trigeminal neuralgia regularly tell me that the recurring episodes of pain are disabling and disrupt every aspect of their life. This vicious cycle of pain without warning disrupts their daily activities, such as eating, sleeping, talking and exercising. We want to help them regain control over their lives and lessen their pain."

Trigeminal Neuralgia Symptoms

Here is a list of symptoms our patients most commonly report:

  • Pain in areas supplied by the trigeminal nerve, including the cheek, jaw, teeth, gums, lips or less often the eye and forehead
  • Pain often affecting just one side of the face
  • Stabbing, shooting, electrical, intermittent facial pain, which can last from a few seconds to several minutes
  • Attacks of facial pain that become more frequent and intense over time
  • Spontaneous attacks of pain or attacks triggered by things such as touching the face, chewing, speaking or brushing teeth
  • Exacerbations of several attacks lasting days, weeks, months or longer — some people have periods when they experience no pain

"Be sure to make an appointment to see a doctor who specializes in Trigeminal Neuralgia if you have severe, prolonged facial pain that can't be relieved by over-the-counter pain medicines," Dr. Field advises.

If you see your primary care physician first, they may recommend you to one of our neuro experts to get to the bottom of your facial pain and offer the specialized care you need.

Common Triggers

Certain movements/triggers may set off trigeminal neuralgia pain, such as:

  • Applying make-up
  • Brushing your teeth
  • Drinking
  • Eating
  • Encountering a breeze
  • Shaving
  • Smiling
  • Talking
  • Touching your face
  • Washing your face

Treatment Options

"Most common over-the-counter and prescription pain medicines don't relieve trigeminal neuralgia pain. However, there are now advanced treatments that can reduce or eliminate the pain," Dr. Field says.

Your neurologist may recommend one or more of these approaches:

Trigeminal Neuralgia Medications

Trigeminal neuralgia drug therapy uses similar medicines prescribed for seizures. Your neurologist can help you choose the best medicine for you. Most patients start on low doses and slowly increase it with your doctor's supervision until you find the best pain relief.

Trigeminal Nerve Blocks

Three common types of blocks can be performed to treat Trigeminal Neuralgia, known as rhizotomies. Although not often curable, the minimally invasive procedure, which involves removing painful nerves, can provide prolonged relief and be repeated if needed.

Microvascular Decompression (MVD) Surgery

If medication isn't giving you the relief you need, surgery is often the next option. MVD surgery is often curative but requires you to be healthy to undergo surgery. MVD surgery is considered the gold standard in the treatment of Trigeminal Neuralgia.

Stereotactic Radiosurgery – GammaKnife

GammaKnife radiosurgery is another option you may want to explore. It is a non-invasive procedure that utilizes powerful doses of radiation to treat diseased brain tissue while leaving surrounding tissue unharmed — accurate to within one millimeter of the targeted area.

"This technology allows us to directly treat the affected area, maximizing accuracy, safety and patient comfort," says Dr. Field. GammaKnife is often utilized when MVD surgery is not an option and medications are no longer providing relief.

Your Care Team for Trigeminal Neuralgia and Beyond

The AdventHealth Neuroscience Institute is a state-of-the-art facility for patients affected by various neurological conditions, including trigeminal neuralgia. We specialize in minimally invasive treatments that pinpoint constricted blood vessels so surgeons can alleviate the pressure on the nerve and eliminate the pain caused by trigeminal neuralgia.

If this type of pain impacts your life, we want to help you find effective relief. Check out our page for more information on trigeminal neuralgia and how we can help you live healthy, happy and whole.

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