Nerve Pain

Nerve-related pain in the face, head, or inside the mouth is often described as a burning or shooting sensation.
It may occur suddenly or persist over time and can be triggered by everyday activities such as talking, chewing,
or touching the area.

• Trigeminal Neuralgia
  • Other Names
    • Tic douloureux
  • What is Trigeminal Neuralgia
    • Trigeminal neuralgia is often described as an Electric shock, shooting, stabbing or sharp pain
    • Pain is triggered by light touch in the “trigger zone.” The most common trigger sites are the side of the nose,
      the upper lip, the cheek, and the lower lip. Pain can also be triggered by touching inside the mouth,
      the tongue or the teeth.
    • Pain usually only occurs one side of the face and is more common along the lower 2/3rd of the face.
    • Pain attacks typically last from anywhere from a few seconds to a few minutes
    • After an attack has been triggered, there is usually a “refractory period” where additional attacks
      cannot be triggered again for several seconds or minutes.
  • How common is Trigeminal Neuralgia?
    • Trigeminal Neuralgia affects between 0.03-0.3% of the population (Porto de Toledo et al. 2016).
  • How is Trigeminal Neuralgia diagnosed?
    • Trigeminal Neuralgia is diagnosed by a doctor, usually a Neurologist, Neurosurgeon or Orofacial Pain Specialist.
    • Your doctor will usually order an MRI to make sure there are no other medical conditions or growths
      in the brain or face that could be causing your symptoms.
    • Your doctor will ask you questions about your pain, do a physical exam, and may need to observe an attack
      to measure how long it lasts, and how quickly it can be triggered again.
    • Your doctor may use special equipment or injections of anesthetic to test the condition of the nerves
      in your face.
  • What kind of doctor treats Trigeminal Neuralgia?
    • Trigeminal neuralgia can be treated by a Neurologist, Neurosurgeon, or an Orofacial Pain Specialist.
      It is important that your doctor has experience in diagnosing and treating Trigeminal Neuralgia,
      because many other conditions can be mistaken for it, including dental infections, sinus infections,
      ear infections, muscle pain, headaches, or trauma.
  • What causes Trigeminal Neuralgia?
    • In 80-90% cases, Trigeminal Neuralgia is caused by a blood vessel rubbing against the trigeminal nerve.
    • Trigeminal Neuralgia can also be caused by conditions like Multiple Sclerosis,
      or from growth in the face or brain.
    • In some cases, nerve condition tests and MRI results might not show a specific cause of Trigeminal Neuralgia.
      In these cases, we use the term “Idiopathic Trigeminal Neuralgia” to signify that we are unsure of exactly
      where the pain is coming from.
  • Who is at risk for trigeminal neuralgia?
    • Trigeminal Neuralgia most often affects people over the age of 50.
    • Women are affected more often than men.
    • If a younger person has symptoms of trigeminal neuralgia, other systemic conditions like Multiple Sclerosis
      or growth in the face or brain need to be ruled out by a doctor.
  • How is Trigeminal Neuralgia treated?
    • Trigeminal neuralgia is most often treated with medications in the “anti-seizure” category,
      because they help reduce the abnormal electrical activity of nerves.
    • If medication management fails, surgical options can be considered.
    • A procedure called Microvascular Decompression is often considered when an MRI shows that a blood vessel
      is rubbing against the trigeminal nerve. During this procedure, your surgeon will slip a small piece of
      Teflon between the nerve and the blood vessel to protect it from trauma.
    • Other procedures use techniques to reduce the nerve conduction including Radiofrequency Thermocoagulation,
      Balloon Compression, Gamma Knife and Glycerol Injection.
• Post-herpetic Neuralgia
• Occipital Neuralgia
• Glossopharyngeal Neuralgia
• Post-traumatic Trigeminal Neuropathic Pain
• Persistent Idiopathic Facial Pain
• Burning Mouth Syndrome