University of California San Francisco | About UCSF | UCSF Benioff Children's Hospital San Francisco
Search Site | Find a Doctor

Trigeminal Neuralgia

Trigeminal neuralgia is a nerve disorder that causes a stabbing or electric shock-like pain in parts of the face.

The pain comes from the trigeminal nerve, the major sensory nerve of the face and surrounding areas, and one of the largest nerves in the head. This nerve is responsible for sending impulses of touch, pain, pressure and temperature to the brain from the face, jaw, gums and tongue. Injuries to the trigeminal nerve can sometimes result from dental treatments such as dental injections, root canals, insertion of dental implants, removal of teeth or other surgical treatments.

This condition can be extremely distressing for patients. Although most patients regain normal sensation and function within a few weeks or months, some are left with abnormal sensation or pain, which can cause problems with speech and chewing.

Symptoms of trigeminal neuralgia include:

  • Very painful, sharp, electric shock-like spasms that usually last a few seconds or minutes, but can become constant.
  • Pain usually occurs on one side of the face only, often around the eye, cheek and lower part of the face.
  • Pain may be triggered by touch or sounds, or by everyday activities such as brushing teeth, chewing, drinking, eating, shaving and light touch on the face.

To confirm the diagnosis of trigeminal neuralgia and exclude other treatable causes of face pain, you will undergo a neurologic evaluation, an MRI of the head, or both. Your doctor will also evaluate the severity of your pain, your general medical condition, and your treatment goals versus risk aversion.

Medication management is always the first line of treatment for trigeminal neuralgia. Patients who continue to experience pain despite the best medical management will be evaluated for surgery. Our surgeons offer a variety of surgical approaches, listed below.

Microvascular Decompression

Microvascular decompression (MVD), also known as the Janetta procedure, is the most common surgical procedure for treating trigeminal neuralgia. In the procedure, the surgeon makes a small incision behind the ear and drills a small hole in the skull. Using microscopic visualization, the trigeminal nerve is exposed. In most cases, there is a blood vessel — typically an artery, but sometimes a vein — compressing the trigeminal nerve. By moving this blood vessel away from the nerve and interposing a padding made of Teflon felt, the pain is nearly always relieved.

Show More

UCSF Research & Clinical Trials

 

Reviewed by health care specialists at UCSF Medical Center.

Related Information

UCSF Clinics & Centers

Neurology and Neurosurgery

Trigeminal Neuralgia
400 Parnassus Ave., Eighth Floor
San Francisco, CA 94143
Phone: (415) 353-2241
Fax: (415) 353-2889
Appointment information

Patient Services