What it is
The trigeminal nerve carries sensation from the face. In classical trigeminal neuralgia, a nearby blood vessel compresses the nerve root. Less often, it is linked to multiple sclerosis or a mass. Some people also have a constant background ache between attacks.
How it is diagnosed
The pattern of attacks on history and exam, plus an MRI of the brain with detailed views of the trigeminal nerve to find the cause and rule out others. Dental and sinus causes are also considered.
How we approach it
- Carbamazepine (FDA-approved for trigeminal neuralgia) as first-line medicine, with blood test monitoring. Oxcarbazepine is a common off-label alternative.
- Other medicines added or substituted when needed, with attention to side effects.
- Selected nerve blocks for short-term relief during severe flares, when appropriate.
- Referral to a neurosurgeon to discuss microvascular decompression, radiosurgery or percutaneous procedures when medicine does not control the pain or is not tolerated.
- Coordination with your neurologist and dentist.
Related treatments
Related conditions
Common
questions.
When to seek urgent care
New facial numbness, weakness, vision changes or facial pain with fever need prompt medical evaluation.
Sources
This page is general information, not medical advice. Individual results vary. Medical Disclaimer