Trigeminal Neuralgia

Key facts

• Trigeminal neuralgia causes sudden, severe facial pain along the trigeminal nerve, often described as electric-shock or stabbing jolts lasting seconds to two minutes.
• Attacks can be triggered by light touch, chewing, speaking, or even a breeze on the face.
• Most cases happen when a blood vessel presses against the nerve root and wears away its protective sheath; multiple sclerosis or a tumor cause a smaller share.
• First-line treatment is an anticonvulsant, carbamazepine, which stabilizes nerve membranes and reduces how often and how badly attacks strike.

What drives the pain

The trigeminal nerve carries sensation from the face to the brain through three branches covering the forehead, cheek, and jaw. In most cases, a blood vessel presses against the nerve root near the brainstem and gradually wears away its protective myelin sheath, so the nerve starts firing abnormal pain signals. Less often, multiple sclerosis or a tumor is the cause. The condition shows up more after age 50 and is somewhat more common in women.

How it's treated

Anticonvulsant medicines are the first approach. Carbamazepine stabilizes nerve membranes and reduces the frequency and intensity of pain episodes for most people; it belongs to the broader neurology medicine group. When pain becomes unmanageable with medicine alone, surgical options such as microvascular decompression or stereotactic radiosurgery may be worth discussing with a specialist.

When to see a doctor

Seek prompt medical review if attacks suddenly get worse, come with new neurological symptoms such as numbness or weakness, or stop responding to treatment.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.