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Trigeminal Neuralgia

What are the trigeminal nerve branches?

The trigeminal nerve has three branches that perform distinct functions:

  • Ophthalmic:  Ophthalmic refers to the eye. The ophthalmic nerve relates to your eyes, upper eyelids and forehead.

  • Maxillary:  The maxillary nerves extend to your cheeks, nose, lower eyelids and upper lip and gums.

  • Mandibular: The mandibular (lower jaw) branch aids sensation to the lower part of your face, such as the jaws, lower lip, and gum.

  • A trigeminal nerve injury may affect a small area and can cause problems with chewing and speaking. The extent depends on where the nerve damage occurs.

  • You may have ongoing numbness or facial pain in the area that the nerve serves.

  • Trigeminal neuralgia may impact any one of these three distributions (or all of them).


What are the signs of trigeminal neuralgia?

Trigeminal neuralgia tends to affect only one side of your face. Some people develop facial twitches (tics) after the pain subsides. the United States.

  • Trigeminal neuralgia most frequently affects people older than 50, and the condition is more common in women than men.

  • Trigeminal neuralgia is the most common cause of facial pain and is diagnosed in approximately 15,000 people per year in the United States.

  • Trigeminal neuralgia pain is exceptionally severe. Although the condition is not life-threatening, the intensity of the pain can be debilitating.

  • Trigeminal neuralgia relief is possible: Medical and surgical treatments can bring the pain under control, especially when managed by an expert physician and surgeon.


Trigeminal neuralgia symptoms may include one or more of these patterns:

  • Episodes of severe, shooting, or jabbing pain that may feel like an electric shock

  • Spontaneous attacks of pain or attacks triggered by things such as touching the face, chewing, speaking or brushing teeth

  • Attacks of pain lasting from a few seconds to several minutes

  • Pain that occurs with facial spasms

  • Bouts of multiple attacks lasting days, weeks, months or longer — some people have periods when they experience no pain

  • Pain in areas supplied by the trigeminal nerve, including the cheek, jaw, teeth, gums, lips, or less often the eye and forehead

  • Pain affecting one side of the face at a time

  • Pain focused in one spot or spread in a wider pattern

  • Pain rarely occurring at night while sleeping

  • Attacks that become more frequent and intense over time


How are trigeminal nerve problems diagnosed?

Trigeminal nerve problems can be challenging to diagnose because there isn’t a specific test to assess the health of these nerves. In addition, other conditions like cluster headaches, temporomandibular and dental disorders, and sinus infections can cause facial pain and produce similar symptoms.

Your healthcare provider may rely on symptoms and a physical examination to make a diagnosis. You may also get an MRI, CT scan or X-rays. These tests can show if a cyst, tumor, or artery is pressing against the trigeminal nerve.


Are there treatment options for trigeminal neuralgia?

Medications form the main line of treatment against this disorder. Some patients may have side effects or will not have a sufficient response to medications, and they will then be referred to a neurosurgeon to discuss procedural options. These options include:

  • Microvascular decompression, which involves an open brain surgery with an incision behind the ear to place a soft spacer between the trigeminal nerve and a compressive blood vessel as it exits from the brain stem.

  • Percutaneous rhizotomy or radiofrequency ablation, which involves passing a needle through the cheek to the exit point of the trigeminal nerve from the base of the skull.

  • Gamma Knife radiosurgery, which uses focused radiation beams to target the trigeminal nerve without the need for an incision as an outpatient procedure.


The expected outcomes for each treatment option may be unique to each patient. A detailed conversation with the neurosurgeon can outline the risks, benefits, and alternatives of each of these techniques.

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