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  • Writer's pictureDr. Preethi MS., DNB., (ENT)

Managing Trigeminal Neuralgia: Treatment Options and Coping Strategies

Trigeminal neuralgia is a debilitating condition that affects the trigeminal nerve, a major sensory pathway that carries information from the face to the brain. This condition can cause sudden, severe facial pain that feels like an electric shock or a sharp, stabbing sensation. The pain can be triggered by everyday activities such as eating, drinking, brushing teeth, or even talking. Trigeminal neuralgia can be a very challenging condition to live with, and it can significantly impact a person's quality of life. In this blog post, we'll explore the symptoms, causes, and treatment options for Trigeminal neuralgia. We'll also provide tips for living with this condition and discuss the importance of seeking medical care if you think you may be experiencing Trigeminal neuralgia.


The causes of trigeminal neuralgia may be as follows:

  1. Compression of the trigeminal nerve: The most common cause of trigeminal neuralgia is compression of the trigeminal nerve by an adjacent blood vessel. This can occur when a blood vessel becomes enlarged and presses against the nerve, leading to irritation or damage. This compression can cause sudden, intense facial pain that feels like an electric shock or stabbing sensation.

  2. Nerve damage: Trigeminal neuralgia can also be caused by damage to the trigeminal nerve. This can occur due to injury, infection, or inflammation. When the nerve is damaged, it can send abnormal signals to the brain, leading to the characteristic symptoms of trigeminal neuralgia.

  3. Medical conditions Several medical conditions can cause trigeminal neuralgia. These include:

    • Multiple sclerosis: This is a condition that affects the central nervous system and can cause damage to the myelin sheath that surrounds nerves, including the trigeminal nerve.

    • Tumors: Rarely, tumors can compress the trigeminal nerve, leading to facial pain.

    • Arteriovenous malformation (AVM): This is a condition where the blood vessels in the brain are malformed, which can cause pressure on the trigeminal nerve.

    • Herpes zoster: This is a viral infection that can affect the trigeminal nerve, leading to facial pain.

      1. Risk factors Certain factors can increase a person's risk of developing trigeminal neuralgia. These include:

        • Age: Trigeminal neuralgia is more common in older adults, particularly those over the age of 50.

        • Gender: Women are more likely than men to develop trigeminal neuralgia.

        • Dental work: Dental procedures that involve the mouth or jaw can sometimes cause nerve damage that leads to trigeminal neuralgia.


Features of neuralgia:

  1. Pain: The pain associated with trigeminal neuralgia is typically described as a sharp, stabbing sensation. It can feel like an electric shock or a jolt of lightning in the face. The pain usually occurs on one side of the face, and can be localized to specific areas such as the cheek, jaw, or forehead. The pain can be very intense and can last for a few seconds to a few minutes.

  2. Triggers: Trigeminal neuralgia can be triggered by various everyday activities such as talking, chewing, swallowing, brushing teeth, touching the face, or even a cool breeze. The pain can also be triggered by more subtle stimuli such as smiling or laughing.

  3. Duration of attacks: The pain associated with trigeminal neuralgia typically lasts from a few seconds to a few minutes. However, in some cases, the pain can persist for several hours.

  4. Frequency of attacks: The frequency of trigeminal neuralgia attacks can vary from person to person. Some people may experience a few attacks per day, while others may have several attacks per hour. The attacks can occur in clusters or in a more continuous pattern.

In addition to the characteristic pain, some people with trigeminal neuralgia may experience other symptoms such as muscle spasms, twitching, or aching in the face. These symptoms can occur before, during, or after an attack of pain.


The following are the treatment options available for trigeminal neuralgia:

  1. Medication: The first line of treatment for trigeminal neuralgia is usually medication. Anticonvulsant drugs such as carbamazepine, oxcarbazepine, and gabapentin can help control the pain associated with trigeminal neuralgia. Other drugs such as muscle relaxants, opioids, or antidepressants may also be prescribed to help manage pain and associated symptoms.

  2. Surgical procedures: If medication does not provide relief, surgical procedures may be recommended. These procedures involve damaging or removing the part of the trigeminal nerve responsible for the pain. Some surgical options include:

    • Microvascular decompression: This is a surgical procedure that involves moving a blood vessel that is compressing the trigeminal nerve.

    • Gamma knife radiosurgery: This is a non-invasive procedure that uses radiation to damage the trigeminal nerve and reduce pain.

    • Balloon compression: This is a minimally invasive procedure that involves compressing the trigeminal nerve with a small balloon.

    • Radiofrequency thermocoagulation: This is a procedure that uses heat to damage the part of the trigeminal nerve responsible for the pain.

      1. Complementary therapies: Some people with trigeminal neuralgia may benefit from complementary therapies such as acupuncture, biofeedback, or hypnotherapy. These therapies can help manage pain and associated symptoms and may be used in combination with medication or surgical procedures.

The choice of treatment will depend on the severity of symptoms, the underlying cause of the condition, and other factors such as the person's overall health and medical history.


Living with trigeminal neuralgia can be challenging. Here are ways to cope with the condition to improve the quality of life:

  1. Keep a pain diary: Keeping a pain diary can help you identify triggers and patterns in your pain. This information can be useful for your healthcare provider in determining the best treatment plan for you.

  2. Stress management: Stress can exacerbate pain associated with trigeminal neuralgia. Practicing stress management techniques such as meditation, deep breathing, or yoga can help reduce stress and manage pain.

  3. Maintain a healthy lifestyle: Eating a healthy diet, getting regular exercise, and getting enough sleep can help manage pain and improve overall health. Avoiding triggers such as alcohol or caffeine can also help manage pain.

  4. Avoid exposure to extreme temperatures: Exposure to extreme temperatures such as hot or cold can trigger pain associated with trigeminal neuralgia. Covering your face in cold weather and avoiding hot drinks or food can help manage pain.

  5. Seek support: Living with a chronic condition such as trigeminal neuralgia can be isolating. Seeking support from family, friends, or support groups can help manage the emotional impact of the condition.


It's important to seek medical attention if you're experiencing facial pain consistent with the symptoms of trigeminal neuralgia. Your ENT surgeon/ neurologist/ physician can help you determine the best treatment plan for your specific case. Living with a chronic condition can be challenging, but with the right management strategies, it's possible to improve quality of life and reduce pain.


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