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Face Pain and Trigeminal Neuralgia

Western Massachusetts’ Leader in Trigeminal Neuralgia Care

If you have trigeminal neuralgia, we understand the pain and challenges you face. You don’t have to live with this pain, and you don’t have to deal with it alone.

Our experts at Baystate Health are here to help you find relief. We are the only healthcare system in western Massachusetts that treats trigeminal neuralgia, and we treat more patients for it than some of the state’s largest medical institutions. Patients come from across the country and throughout the world to access our expert care for this painful condition.

What Is Trigeminal Neuralgia?

Trigeminal neuralgia, sometimes called tic douloureux, is a chronic (long-lasting) condition that affects the trigeminal nerve. You have two trigeminal nerves — one on each side of your face. These nerves transmit pain and other sensations from your face to your brain. Most people with trigeminal neuralgia only have one nerve affected by the condition.

The trigeminal nerve has three branches: ophthalmic, maxillary and mandibular. The location of your trigeminal neuralgia pain depends on what part of the trigeminal nerve is affected. Most people feel it in the lower part of their face. 

Trigeminal Neuralgia Symptoms

Severe, recurring pain is the main symptom of trigeminal neuralgia. This pain may include sensations of stabbing or electrical shock in the cheek or jaw. Some people mistake the pain as a result of a dental condition and have teeth removed to try to find relief.

Your pain may last a few seconds to a few minutes at a time. Most people have periods of weeks, months, or longer without pain, followed by episodes of several pain attacks over a long period. Unfortunately, trigeminal neuralgia can progress and cause worsening pain that lasts longer.

What Causes Trigeminal Neuralgia?

In most cases, trigeminal neuralgia results from contact between a blood vessel and the trigeminal nerve. Trigeminal neuralgia can also develop due to multiple sclerosis (MS), because MS can damage the nerve’s myelin sheath (a protective coating). In some cases, trigeminal neuralgia can be the result of a brain tumor.

You may notice that pain attacks from trigeminal neuralgia occur after certain trigger behaviors, such as:

  • Being touched on the face
  • Eating
  • Feeling a light breeze on the face
  • Talking
  • Washing your face

Some patients may avoid eating, talking, and other trigger behaviors to try to avoid the pain.

Most people with trigeminal neuralgia are over 50. However, you can develop the condition at any age. You’re more likely to have trigeminal neuralgia at a younger age if you’ve been diagnosed with MS. Women are also more likely to develop this condition than men.

How We Diagnose Trigeminal Neuralgia

Your doctor will ask you a series of questions and ask you to describe your pain. Based on the type of pain you experience, where the pain is located, and what actions or behaviors trigger your pain, we’ll determine whether you may have trigeminal neuralgia.

Next, we’ll prescribe a medication called carbamazepine (Tegretol or Carbatrol), which is commonly used to treat seizures. If this medication relieves your pain, you likely have trigeminal neuralgia.

If your doctor diagnoses you with trigeminal neuralgia, you’ll need a magnetic resonance imaging (MRI) exam. This is to make sure your trigeminal neuralgia isn’t the result of MS or a brain tumor, both of which can affect your treatment plan.

How We Treat Trigeminal Neuralgia

Our expert neurology and neurosurgery team will discuss your treatment options and help you decide which is best for you.

Trigeminal Neuralgia Medicines

Many people manage this condition for long periods of time with medication. Your neurologist can help you find the best treatment.

Trigeminal Neuralgia Surgery

If medication no longer works to control your facial pain, there are surgical options available including Microvascular Decompression and Glycerol Rhizotomy.  Learn more about our neurosurgical treatments for trigeminal neuralgia.

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